Global Health Action最新文献

{"title":"The contextual awareness, response and evaluation (CARE) diabetes project: study design for a quantitative survey of diabetes prevalence and non-communicable disease risk in Ga Mashie, Accra, Ghana.","authors":"Swaib Abubaker Lule, Sandra Boatemaa Kushitor, Carlos S Grijalva-Eternod, Kafui Adjaye-Gbewonyo, Olutobi Adekunle Sanuade, Mawuli Komla Kushitor, Lydia Okoibhole, Raphael Awuah, Leonard Baatiema, Irene Akwo Kretchy, Daniel Arhinful, Ama de-Graft Aikins, Kwadwo Koram, Edward Fottrell","doi":"10.1080/16549716.2023.2297513","DOIUrl":"10.1080/16549716.2023.2297513","url":null,"abstract":"<p><p>Diabetes is estimated to affect between 3.3% and 8.3% of adults in Ghana, and prevalence is expected to rise. The lack of cost-effective diabetes prevention programmes designed specifically for the Ghanaian population warrants urgent attention. The Contextual Awareness, Response and Evaluation (CARE): Diabetes Project in Ghana is a mixed methods study that aims to understand diabetes in the Ga Mashie area of Accra, identify opportunities for community-based intervention and inform future diabetes prevention and control strategies. This paper presents the study design for the quantitative survey within the CARE project. This survey will take place in the densely populated Ga Mashie area of Accra, Ghana. A household survey will be conducted using simple random sampling to select households from 80 enumeration areas identified in the 2021 Ghana Population and Housing Census. Trained enumerators will interview and collect data from permanent residents aged ≥ 25 years. Pregnant women and those who have given birth in the last six months will be excluded. Data analysis will use a combination of descriptive and inferential statistics, and all analyses will account for the cluster sampling design. Analyses will describe the prevalence of diabetes, other morbidities, and associated risk factors and identify the relationship between diabetes and physical, social, and behavioural parameters. This survey will generate evidence on drivers and consequences of diabetes and facilitate efforts to prevent and control diabetes and other NCDs in urban Ghana, with relevance for other low-income communities.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2297513"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the exodus: a 15-year retrospective cohort study on the pattern and determinants of migration among Nigerian doctors and dentists.","authors":"Oghenebrume Wariri, Patience Toyin-Thomas, Itua C G Akhirevbulu, Oladapo Oladeinde, Oluchi Omogbai, Philippa Odika, John Osakue, Avwebo Ukueku, Efetobo Orikpete, Chinelo Iwegim, Efe E Omoyibo, Jermaine Okpere, Uwaila Otakhoigbogie, Ekhosuehi T Agho, Sunday C Madubueze, Nnennaya C Ugoji, Chukwunwike W Ozegbe, Oti N Aria, Paul Ikhurionan","doi":"10.1080/16549716.2024.2432754","DOIUrl":"10.1080/16549716.2024.2432754","url":null,"abstract":"<p><strong>Background: </strong>Nigeria faces a critical shortage of healthcare professionals yet experiences a significant annual exodus of doctors and dentists. This alarming trend threatens the country's ability to provide equitable healthcare.</p><p><strong>Objective: </strong>This study investigated the patterns and determinants of migration among doctors and dentists who graduated from the University of Benin, Nigeria, 15 years ago.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study that tracked 274 of the 379 (72.3%) eligible cohort. We computed the migration incidence rate per person-year from 2008 to 2023, covering 3,455 person-years of follow-up and analysed migration drivers as push and pull factors across macro-, meso-, and micro-levels.</p><p><strong>Results: </strong>Fifteen years post-graduation, 48.9% (134/274) of the cohort had migrated. While the annual incidence rate of migration remained stable for the first 8 years, it spiked after 2016, reaching 11.4 per 100 person-years in 2023. Among those who migrated, the majority (96.3%, 129/134) relocated outside the African continent. The top three destination countries were the UK (48.5%, 65/134), Canada (20.9%, 28/134), and the USA (19.4%, 26/134). The leading push factors were insecurity of lives and property (57.8%), concerns about children's futures (50.3%), and limited career development opportunities (45.9%). The primary pull factors included security (56.3%), permanent residency (49.6%), and better pay in the destination country (46.7%). Significant predictors of migration included younger age, timing of marriage, and residency training status.</p><p><strong>Conclusions: </strong>To avert an impending crisis, the Nigerian government must address the root causes driving the increasing migration of doctors and dentists.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2432754"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validating the diagnostic accuracy of medical certification: a population-level comparison between verbal autopsy and Saudi medical records causes of death of deceased with type 2 diabetes.","authors":"Faleh Alyazidi, Deler Shakely, Fawaz R Alyazidi, Max Petzold, Laith Hussain-Alkhateeb","doi":"10.1080/16549716.2024.2448382","DOIUrl":"10.1080/16549716.2024.2448382","url":null,"abstract":"<p><strong>Background: </strong>In contexts where certifying causes of death (COD) is inadequate - either in industrialized or non-industrialized countries - verbal autopsy (VA) serves as a practical method for determining probable COD, helping to address gaps in vital data.</p><p><strong>Objective: </strong>This study aimed to validate the diagnostic accuracy of medical certifications at a population level by comparing COD obtained from medical records against those derived from VA in Saudi Arabia.</p><p><strong>Method: </strong>Death records from 2018 to 2021 were collected from a type 2 diabetes mellitus register at a major specialist hospital in Makkah. Three hundred and two VA interviews were completed with deceased patients' relatives, and the probable COD was determined using InterVA-5 software. Lin's concordance correlation coefficient was applied to examine similarities of the cause-specific mortality fractions (CSMFs) based on International Classification of Diseases chapters from both verbal autopsy causes of death (VACOD) and the physician review causes of death (PRCOD).</p><p><strong>Results: </strong>Overall, the findings demonstrated a moderate level of concordance of COD at the population between VACOD and PRCOD. However, the CSMFs for various COD categories derived from both sources showed a broad spectrum of absolute differences, with the largest disparities observed among the most prevalent COD categories.</p><p><strong>Conclusion: </strong>PRCOD was found to overestimate population-level endocrine/metabolic and respiratory disease COD while underestimating circulatory disease, demonstrating medical certification challenges. Conversely, affirming previous literature on prevalent COD in Saudi Arabia, VA appears to deliver a plausible assessment, further strengthening its potential to integrate within the Saudi health system towards an augmented medical certification process.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2448382"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial inclusion for people with disability: a scoping review.","authors":"Louise Puli, Natasha Layton, Diane Bell, Abu Zafar Shahriar","doi":"10.1080/16549716.2024.2342634","DOIUrl":"10.1080/16549716.2024.2342634","url":null,"abstract":"<p><strong>Background: </strong>Financial exclusion is a human rights issue affecting health equity. Evidence demonstrates that financial exclusion is exacerbated for people with disability and those in low- to middle-income countries (LMIC). Barriers to financial access include limited demand for services, banking inadequacies in catering to people with disability, and insufficiently accessible information technologies (ICT) and infrastructure.</p><p><strong>Objectives: </strong>This scoping review sought to identify barriers to and facilitators of financial inclusion for people with disability in LMIC. As a secondary objective, the study explored the potential of financial education and ICT utilisation as viable strategies for enhancing financial inclusion.</p><p><strong>Methods: </strong>This review utilised the Arksey and O'Malley framework and PRISMA Checklist for systematic literature examination and data extraction. The WHO's Environmental Factors guided the analysis to propose potential interventions and to generate recommendations.</p><p><strong>Results: </strong>The review analysed 26 publications from various global regions and fields including finance, business, technology, health and disability policy. It identified consistent financial inclusion barriers for people with disability, resulting in a set of global recommendations across attitudes, environment, technology, services, and policy.</p><p><strong>Conclusions: </strong>Recommendations include using ICT, digital innovation and multi-stakeholder collaboration to address the financial barriers experienced by people with disability. These efforts, rooted in social justice, aim to include people with disability in LMIC as valued financial sector participants, promoting health and equity.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2342634"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic on type 2 diabetes care and factors associated with care disruption in Kenya and Tanzania.","authors":"Richard E Sanya, Caroline H Karugu, Peter Binyaruka, Shukri F Mohamed, Lyagamula Kisia, Peter Kibe, Irene Mashasi, Grace Mhalu, Christopher Bunn, Manuela Deidda, Frances S Mair, Eleanor Grieve, Cindy M Gray, Sally Mtenga, Gershim Asiki","doi":"10.1080/16549716.2024.2345970","DOIUrl":"10.1080/16549716.2024.2345970","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic affected healthcare delivery globally, impacting care access and delivery of essential services.</p><p><strong>Objectives: </strong>We investigated the pandemic's impact on care for patients with type 2 diabetes and factors associated with care disruption in Kenya and Tanzania.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among adults diagnosed with diabetes pre-COVID-19. Data were collected in February-April 2022 reflecting experiences at two time-points, three months before and the three months most affected by the COVID-19 pandemic. A questionnaire captured data on blood glucose testing, changes in medication prescription and access, and healthcare provider access.</p><p><strong>Results: </strong>We recruited 1000 participants (500/country). Diabetes care was disrupted in both countries, with 34.8% and 32.8% of the participants reporting change in place and frequency of testing in Kenya, respectively. In Tanzania, 12.4% and 17.8% reported changes in location and frequency of glucose testing, respectively. The number of health facility visits declined, 14.4% (<i>p</i> < 0.001) in Kenya and 5.6% (<i>p</i> = 0.001) in Tanzania. In Kenya, there was a higher likelihood of severe care disruption among insured patients (adjusted odds ratio [aOR] 1.56, 95% confidence interval [CI][1.05-2.34]; <i>p</i> = 0.029) and a lower likelihood among patients residing in rural areas (aOR, 0.35[95%CI, 0.22-0.58]; <i>p</i> < 0.001). Tanzania had a lower likelihood of severe disruption among insured patients (aOR, 0.51[95%CI, 0.33-0.79]; <i>p</i> = 0.003) but higher likelihood among patients with low economic status (aOR, 1.81[95%CI, 1.14-2.88]; <i>p</i> = 0.011).</p><p><strong>Conclusions: </strong>COVID-19 disrupted diabetes care more in Kenya than Tanzania. Health systems and emergency preparedness should be strengthened to ensure continuity of service provision for patients with diabetes.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2345970"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11123500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distances to emergency departments and non-urgent utilization of medical services: a systematic review.","authors":"Uma Kelekar, Debasree Das Gupta, Nicole Theis-Mahon, Emily Fashingbauer, Boyen Huang","doi":"10.1080/16549716.2024.2353994","DOIUrl":"10.1080/16549716.2024.2353994","url":null,"abstract":"<p><strong>Background: </strong>The use of Emergency Departments (EDs) for non-urgent medical conditions is a global public health concern.</p><p><strong>Objectives: </strong>A systematic review, guided by a registered protocol (PROSPERO: CRD42023398674), was conducted to interpret the association between distance as a measure of healthcare access and the utilization of EDs for non-urgent care in high- and middle-income countries.</p><p><strong>Methods: </strong>The search was conducted on 22 August 2023 across five databases using controlled vocabulary and natural language keywords. Eligibility criteria included studies that examined non-urgent care, and featured concepts of emergency departments, non-urgent health services and distance, reported in English. Articles and abstracts where patients were transported by ambulance/paramedic services, referred/transferred from another hospital to an ED, or those that measured distance to an ED from another health facility were excluded. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework informed the quality of evidence.</p><p><strong>Results: </strong>Fifteen articles met the inclusion criteria. All studies demonstrated satisfactory quality with regard to study design, conduct, analysis and presentation of results. Eight (53.3%) of the studies (1 paediatric, 4 all ages/adult, 3 ecological) found a moderate level of evidence of an inverse association between distance and ED visit volume or utilization for non-urgent medical conditions, while the remaining studies reported very low or low evidence.</p><p><strong>Conclusions: </strong>Half of the studies reported non-urgent ED use to be associated with shortest distance traveled or transportation time. This finding bears implications for healthcare policies aiming to reduce ED use for non-urgent care.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2353994"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality and resilience of clinical laboratories in Rwanda: a need for sustainable strategies.","authors":"Vincent Rusanganwa, Innocent Nzabahimana, Magnus Evander","doi":"10.1080/16549716.2024.2358633","DOIUrl":"10.1080/16549716.2024.2358633","url":null,"abstract":"<p><strong>Background: </strong>Quality healthcare is a global priority, reliant on robust health systems for evidence-based medicine. Clinical laboratories are the backbone of quality healthcare facilitating diagnostics, treatment, patient monitoring, and disease surveillance. Their effectiveness depends on sustainable delivery of accurate test results. Although the Strengthening Laboratory Management Towards Accreditation (SLMTA) programme has enhanced laboratory quality in low-income countries, the long-term sustainability of this improvement remains uncertain.</p><p><strong>Objective: </strong>To explore the sustainability of quality performance in clinical laboratories in Rwanda following the conclusion of SLMTA.</p><p><strong>Methods: </strong>A quasi-experimental design was adopted, involving 47 laboratories divided into three groups with distinct interventions. While one group received continuous mentorship and annual assessments (group two), interventions for the other groups (groups one and three) ceased following the conclusion of SLMTA. SLMTA experts collected data for 10 years through assessments using WHO's StepwiseLaboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. Descriptive and t-test analyses were conducted for statistical evaluation.</p><p><strong>Results: </strong>Improvements in quality were noted between baseline and exit assessments across all laboratory groups (mean baseline: 35.3%, exit: 65.8%, <i>p</i> < 0.001). However, groups one and three experienced performance declines following SLMTA phase-out (mean group one: 64.6% in reference to 85.8%, <i>p</i> = 0.01; mean group three: 57.3% in reference to 64.7%, <i>p</i> < 0.001). In contrast, group two continued to enhance performance even years later (mean: 86.6%compared to 70.6%, <i>p</i> = 0.03).</p><p><strong>Conclusion: </strong>A coordinated implementation of quality improvement plan that enables regular laboratory assessments to pinpoint and address the quality gaps is essential for sustaining quality services in clinical laboratories.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2358633"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Starting then stopping: a nationwide register-based study on the magnitude, predictors, and urban-rural patterns of under-vaccination variation across health centers in The Gambia.","authors":"Alieu Sowe, Fredinah Namatovu, Bai Cham, Per E Gustafsson","doi":"10.1080/16549716.2024.2348788","DOIUrl":"10.1080/16549716.2024.2348788","url":null,"abstract":"<p><strong>Objectives: </strong>Six million children were under-vaccinated in 2022. Our study aimed to 1) quantify the magnitude of under-vaccination variation between health facilities, 2) assess to which extent individual and health center level factors contributed to the variation, 3) identify individual and health facility factors associated with under-vaccination, and 4), explore rural vs. urban health facility variations.</p><p><strong>Methods: </strong>We used data from 61,839 children from The Gambia national routine vaccination register. We cross tabulated under-vaccination status across study variables and fitted two-level random intercept multilevel logistic regression models to measure variance, contribution to the variance, and factors associated with the variance and under-vaccination.</p><p><strong>Results: </strong>We found that 7% of the prevalence of under-vaccination was due to variation between health facilities. Thirty-seven percent of the variation was explained by individual and health center variables. The variables explained 36% of the variance in urban and 19% in rural areas. Children who were not vaccinated at 4 months or with delayed history, due for vaccination in the rainy season, and health facilities with very small or large population to health worker ratios had higher under-vaccination odds.</p><p><strong>Conclusion: </strong>Our study indicates that one of the pathways to improving vaccination coverage is addressing factors driving under-vaccination inequities between health facilities through urban-rural differentiated strategies.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2348788"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"When you provide abortion services, you are looked upon as a bad guy\": experiences of abortion stigma by health providers in Nigeria.","authors":"Friday Okonofua, Lorretta Ntoimo, Louise Bury, Suzanna Bright, Lesley Hoggart","doi":"10.1080/16549716.2024.2401849","DOIUrl":"10.1080/16549716.2024.2401849","url":null,"abstract":"<p><strong>Background: </strong>Abortion stigma as reported globally has been inadequately documented empirically in Nigeria, Africa's most populous country with a restrictive abortion law and a high rate of unsafe abortions.</p><p><strong>Objective: </strong>The objectives of this study were to investigate the ways in which abortion stigma is experienced by Nigerian health professionals and how such experiences influence health professionals' practice of safe abortion and post-abortion care.</p><p><strong>Methods: </strong>The study utilized qualitative research consisting of in-depth interviews with 10 abortion providers. We elicited information with an open-ended interview guide that investigated the understanding of participants' experiences of abortion stigma in Nigeria. The data were analysed qualitatively and thematically using Atlas.ti.</p><p><strong>Results: </strong>The themes centred on perceptions and experiences of stigma among the providers interviewed. Participants' experiences of abortion stigma included the following: being treated differently to other health professionals; experiencing disapproval and disrespect; name-calling and societal judgement; tagging and profiling of clinics by anti-abortionists; and social isolation. Participants attributed stigma to cultural and religious beliefs, the restrictive national abortion law, and pointed to hypocrisy. Some reported effects of stigma on providers included a feeling of insecurity, social exclusion, secrecy, and insincerity in clinical practice, discouragement, and guilt feelings. Despite the negative impacts, many respondents reported a sense of satisfaction stemming from their views that they were saving lives.</p><p><strong>Conclusion: </strong>Systematic efforts to address these adverse factors could reduce the level of stigma experienced by providers, with a potential follow-through effect of improving women's access to safe abortion care in Nigeria.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2401849"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Form and functioning: contextualising the start of the global financing facility policy processes in Burkina Faso.","authors":"Joël Arthur Kiendrébéogo, Orokia Sory, Issa Kaboré, Yamba Kafando, Meghan Bruce Kumar, Asha S George","doi":"10.1080/16549716.2024.2360702","DOIUrl":"10.1080/16549716.2024.2360702","url":null,"abstract":"<p><strong>Background: </strong>Burkina Faso joined the Global Financing Facility for Women, Children and Adolescents (GFF) in 2017 to address persistent gaps in funding for reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N). Few empirical papers deal with how global funding mechanisms, and specifically GFF, support resource mobilisation for health nationally.</p><p><strong>Objective: </strong>This study describes the policy processes of developing the GFF planning documents (the Investment Case and Project Appraisal Document) in Burkina Faso.</p><p><strong>Methods: </strong>We conducted an exploratory qualitative policy analysis. Data collection included document review (<i>N</i> = 74) and in-depth semi-structured interviews (<i>N</i> = 23). Data were analysed based on the components of the health policy triangle.</p><p><strong>Results: </strong>There was strong national political support to RMNCAH-N interventions, and the process of drawing up the investment case (IC) and the project appraisal document was inclusive and multi-sectoral. Despite high-level policy commitments, subsequent implementation of the World Bank project, including the GFF contribution, was perceived by respondents as challenging, even after the project restructuring process occurred. These challenges were due to ongoing policy fragmentation for RMNCAH-N, navigation of differing procedures and perspectives between stakeholders in the setting up of the work, overcoming misunderstandings about the nature of the GFF, and weak institutional anchoring of the IC. Insecurity and political instability also contributed to observed delays and difficulties in implementing the commitments agreed upon. To tackle these issues, transformational and distributive leaderships should be promoted and made effective.</p><p><strong>Conclusions: </strong>Few studies have examined national policy processes linked to the GFF or other global health initiatives. This kind of research is needed to better understand the range of challenges in aligning donor and national priorities encountered across diverse health systems contexts. This study may stimulate others to ensure that the GFF and other global health initiatives respond to local needs and policy environments for better implementation.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2360702"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11198144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}