Health systems and reform最新文献_第8页

Communication and Information Strategies Implemented by Four Hospitals in Brazil, Canada, and France to Deal with COVID-19 Healthcare-Associated Infections. 巴西、加拿大和法国四家医院应对COVID-19医疗保健相关感染的沟通和信息战略

Health systems and reform Pub Date : 2023-06-15 DOI: 10.1080/23288604.2023.2223812

Renyou Hou, Lola Traverson, Fanny Chabrol, Lara Gautier, Sydia Rosana de Araújo Oliveira, Pierre-Marie David, Jean-Christophe Lucet, Kate Zinszer, Valéry Ridde

{"title":"Communication and Information Strategies Implemented by Four Hospitals in Brazil, Canada, and France to Deal with COVID-19 Healthcare-Associated Infections.","authors":"Renyou Hou, Lola Traverson, Fanny Chabrol, Lara Gautier, Sydia Rosana de Araújo Oliveira, Pierre-Marie David, Jean-Christophe Lucet, Kate Zinszer, Valéry Ridde","doi":"10.1080/23288604.2023.2223812","DOIUrl":"https://doi.org/10.1080/23288604.2023.2223812","url":null,"abstract":"During the COVID-19 pandemic outbreak, COVID-19 healthcare-associated infections (HAI) and risk management became major challenges facing hospitals. Using evidence from a research project, this commentary presents: 1) various communication and information strategies implemented by four hospitals and their staff in Brazil, Canada and France to reduce the risks of COVID-19 HAIs, and how they were perceived by hospital staff; 2) the flaws in communication in the hospitals; and 3) a proposed agenda for research on and action to improve institutional communications for future pandemics. By analyzing \"top-down\" strategies at the organizational level and spontaneous strategies initiated by and between professionals, this study shows that during the first waves of the pandemic, reliable information and clear communication about guidelines and health protocols' changes can help alleviate fears among staff and avoid misapplication of protocols, thereby reducing infection risks. There was a lack of a \"bottom-up\" communication channel, while, when making decisions, it is crucial to listen to and fully take into account staff's voices, experiences, and feelings. More balanced communication between hospital administrators and staff could strengthen team cohesion and lead to better enforcement of protocols, which in turn will reduce the risk of contamination, alleviate the potential impacts on staff health, and improve the quality of care provided to patients.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 2","pages":"2223812"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10169785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

How Did an Integrated Health and Social Services Center in the Quebec Province Respond to the COVID-19 Pandemic? A Qualitative Case Study. 魁北克省的综合卫生和社会服务中心如何应对COVID-19大流行?定性案例研究。

Health systems and reform Pub Date : 2023-06-15 DOI: 10.1080/23288604.2023.2186824

Morgane Gabet, Arnaud Duhoux, Valéry Ridde, Kate Zinszer, Lara Gautier, Pierre-Marie David

{"title":"How Did an Integrated Health and Social Services Center in the Quebec Province Respond to the COVID-19 Pandemic? A Qualitative Case Study.","authors":"Morgane Gabet, Arnaud Duhoux, Valéry Ridde, Kate Zinszer, Lara Gautier, Pierre-Marie David","doi":"10.1080/23288604.2023.2186824","DOIUrl":"https://doi.org/10.1080/23288604.2023.2186824","url":null,"abstract":"During the first and second waves of the pandemic, Quebec was among the Canadian provinces with the highest COVID-19 mortality rates. Facing particularly large COVID-19 outbreaks in its facilities, an integrated health and social services center in the province of Quebec (Canada), developed resilience strategies. To explore these diverse responses to the crisis, we conducted a case study analysis of a Quebec integrated health and social services center, building on a conceptualization of resilience strategies using \"configurations\" of effects, strategies, and impacts. Qualitative data from 14 indepth interviews conducted in the summer and fall of 2020 with managers and frontline practitioners were analyzed through the lens of situations of \"anticipation,\" \"reaction,\" or \"inaction.\" The findings were discussed in three results dissemination workshops, two with practitioners and one with managers, to discern lessons they learned. Three major configurations emerged: 1) reorganization of services and spaces to accommodate more COVID-19 patients; 2) management of contamination risks for patients and professionals; and 3) management of personal protective equipment (PPE), supplies, and medications. Within these configurations, the responses to the crisis were strongly shaped by the 2015 health care system reforms in Quebec and were constrained by organizational challenges that included a centralized model of governance, a history of substantial budget cuts to longterm care facilities, and a systematic lack of human resources.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 2","pages":"2186824"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9264176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Adapting Hospital Work During COVID-19 in Quebec (Canada). 加拿大魁北克省COVID-19期间医院工作的调整

Health systems and reform Pub Date : 2023-06-15 DOI: 10.1080/23288604.2023.2200566

Pierre-Marie David, Morgane Gabet, Arnaud Duhoux, Lola Traverson, Valéry Ridde, Kate Zinszer, Lara Gautier

{"title":"Adapting Hospital Work During COVID-19 in Quebec (Canada).","authors":"Pierre-Marie David, Morgane Gabet, Arnaud Duhoux, Lola Traverson, Valéry Ridde, Kate Zinszer, Lara Gautier","doi":"10.1080/23288604.2023.2200566","DOIUrl":"https://doi.org/10.1080/23288604.2023.2200566","url":null,"abstract":"Among hospital responses to the COVID19 pandemic worldwide, service reorganization and staff reassignment have been some of the most prominent ways of adapting hospital work to the expected influx of patients. In this article, we examine work reorganization induced by the pandemic by identifying the operational strategies implemented by two hospitals and their staff to contend with the crisis and then analyzing the implications of those strategies. We base our description and analysis on two hospital case studies in Quebec. We used a multiple case study approach, wherein each hospital is considered a unique case. In both cases, work adaptation through staff reassignment was one of the critical measures undertaken to ensure absorption of the influx of patients into the hospitals. Our results showed that this general strategy was designed and applied differently in the two cases. More specifically, the reassignment strategies revealed numerous healthcare resource disparities not only between health territories, but also between different types of facilities within those territories. Comparing the two hospitals' adaptation strategies showed that past reforms in Quebec determined what these reorganizations could achieve, as well as how they would affect workers and the meaning they gave to their work.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 2","pages":"2200566"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9421115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Lessons Learned from Field Experiences on Hospitals' Resilience to the COVID-19 Pandemic: A Systematic Approach. 从医院应对COVID-19大流行的实地经验中吸取的教训:一种系统方法。

Health systems and reform Pub Date : 2023-06-15 DOI: 10.1080/23288604.2023.2231644

Christian Dagenais, Muriel Kielende, Abdourahmane Coulibaly, Lara Gautier, Pierre-Marie David, Nathan Peiffer-Smadja, Ayako Honda, Sydia Rosana de Araújo Oliveira, Lola Traverson, Kate Zinszer, Valéry Ridde

{"title":"Lessons Learned from Field Experiences on Hospitals' Resilience to the COVID-19 Pandemic: A Systematic Approach.","authors":"Christian Dagenais, Muriel Kielende, Abdourahmane Coulibaly, Lara Gautier, Pierre-Marie David, Nathan Peiffer-Smadja, Ayako Honda, Sydia Rosana de Araújo Oliveira, Lola Traverson, Kate Zinszer, Valéry Ridde","doi":"10.1080/23288604.2023.2231644","DOIUrl":"https://doi.org/10.1080/23288604.2023.2231644","url":null,"abstract":"In this concluding article of the special issue, we examine lessons learned from hospitals' resilience to the COVID-19 pandemic in Brazil, Canada, France, Japan, and Mali. A quality lesson learned (QLL) results from a systematic process of collecting, compiling, and analyzing data derived ideally from sustained effort over the life of a research project and reflecting both positive and negative experiences. To produce QLLs as part of this research project, a guide to their development was drafted. The systematic approach we adopted to formulate quality lessons, while certainly complex, took into account the challenges faced by the different stakeholders involved in the fight against the COVID-19 pandemic. Here we present a comparative analysis of the lessons learned by hospitals and their staff with regard to four common themes that were the subject of empirical analyses: 1) infrastructure reorganization; 2) human resources management; 3) prevention and control of infection risk; and 4) logistics and supply. The lessons learned from the resilience of the hospitals included in this research indicate several factors to consider in preparing for a health crisis: 1) strengthening the coordination and leadership capacities of hospital managers and health authorities; 2) improving communication strategies; 3) strengthening organizational capacity; and 4) adapting resources and strategies, including for procurement and infection risk management.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 2","pages":"2231644"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9871744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Strategic Purchasing Arrangements in Uganda and Their Implications for Universal Health Coverage. 乌干达的战略采购安排及其对全民健康覆盖的影响。

Health systems and reform Pub Date : 2022-03-01 DOI: 10.1080/23288604.2022.2084215

Elizabeth Ekirapa-Kiracho, Aloysius Ssennyonjo, Cheryl Cashin, Agnes Gatome-Munyua, Nkechi Olalere, Richard Ssempala, Chrispus Mayora, Freddie Ssengooba

{"title":"Strategic Purchasing Arrangements in Uganda and Their Implications for Universal Health Coverage.","authors":"Elizabeth Ekirapa-Kiracho, Aloysius Ssennyonjo, Cheryl Cashin, Agnes Gatome-Munyua, Nkechi Olalere, Richard Ssempala, Chrispus Mayora, Freddie Ssengooba","doi":"10.1080/23288604.2022.2084215","DOIUrl":"https://doi.org/10.1080/23288604.2022.2084215","url":null,"abstract":"Several purchasing arrangements coexist in Uganda, creating opportunities for synergy but also leading to conflicting incentives and inefficiencies in resource allocation and purchasing functions. This paper analyzes the key health care purchasing functions in Uganda and the implications of the various purchasing arrangements for universal health coverage (UHC). The data for this paper were collected through a document review and stakeholder dialogue. The analysis was guided by the Strategic Health Purchasing Progress Tracking Framework created by the Strategic Purchasing Africa Resource Center (SPARC) and its technical partners. Uganda has a minimum health care package that targets the main causes of morbidity and mortality as well as specific vulnerable groups. However, provision of the package is patchy, largely due to inadequate domestic financing and duplication of services funded by development partners. There is selective contracting with private-sector providers. Facilities receive direct funding from both the government budget and development partners. Unlike government-budget funding, payment from output-based donor-funded projects and performance-based financing (PBF) projects is linked to service quality and has specified conditions for use. Specification of UHC targets is still nascent and evolving in Uganda. Expansion of service coverage in Uganda can be achieved through enhanced resource pooling and harmonization of government and donor priorities. Greater provider autonomy, better work planning, direct facility funding, and provision of flexible funds to service providers are essential elements in the delivery of high-quality services that meet local needs and Uganda's UHC aspirations.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":" ","pages":"2084215"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40562545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Has Strategic Purchasing Led to Improvements in Health Systems? A Narrative Review of Literature on Strategic Purchasing. 战略采购是否改善了卫生系统?战略采购相关文献述评。

Health systems and reform Pub Date : 2022-03-01 DOI: 10.1080/23288604.2022.2151698

Fred Matovu, Agnes Gatome-Munyua, Richard Sebaggala

{"title":"Has Strategic Purchasing Led to Improvements in Health Systems? A Narrative Review of Literature on Strategic Purchasing.","authors":"Fred Matovu, Agnes Gatome-Munyua, Richard Sebaggala","doi":"10.1080/23288604.2022.2151698","DOIUrl":"https://doi.org/10.1080/23288604.2022.2151698","url":null,"abstract":"Strategic purchasing is noted in the literature as an approach that can improve the efficiency of health spending, increase equity in access to health care services, improve the quality of health care delivery, and advance progress toward universal health coverage. However, the evidence on how strategic purchasing can achieve these improvements is sparse. This narrative review sought to address this evidence gap and provide decision makers with lessons and policy recommendations. The authors conducted a systematic review based on two research questions: 1) What is the evidence on how purchasing functions affect purchasers' leverage to improve: resource allocation, incentives, and accountability; intermediate results (allocative and technical efficiency); and health system outcomes (improvements in equity, access, quality, and financial protection)? and 2) What conditions are needed for a country to make progress on strategic purchasing and achieve health system outcomes? We used database searches to identify published literature relevant to these research questions, and we coded the themes that emerged, in line with the purchasing functions-benefits specification, contracting arrangements, provider payment, and performance monitoring-and the outcomes of interest. The extent to which strategic purchasing affects the outcomes of interest in different settings is partly influenced by how the purchasing functions are designed and implemented, the enabling environment (both economic and political), and the level of development of the country's health system and infrastructure. For strategic purchasing to provide more value, sufficient public funding and pooling to reduce fragmentation of schemes is important.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"8 2","pages":"2151698"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10475722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Effects of Health Purchasing Reforms on Equity, Access, Quality of Care, and Financial Protection in Kenya: A Narrative Review. 肯尼亚医疗采购改革对公平、可及性、医疗质量和财务保护的影响:叙述性回顾。

Health systems and reform Pub Date : 2022-03-01 DOI: 10.1080/23288604.2022.2114173

Evelyn Kabia, Jacob Kazungu, Edwine Barasa

{"title":"The Effects of Health Purchasing Reforms on Equity, Access, Quality of Care, and Financial Protection in Kenya: A Narrative Review.","authors":"Evelyn Kabia, Jacob Kazungu, Edwine Barasa","doi":"10.1080/23288604.2022.2114173","DOIUrl":"https://doi.org/10.1080/23288604.2022.2114173","url":null,"abstract":"Kenya has implemented several health purchasing reforms to facilitate progress toward universal health coverage. We conducted a narrative review of peer-reviewed and grey literature to examine how these reforms have affected health system outcomes in terms of equity, access, quality of care, and financial protection. We categorized the purchasing reforms we identified into the areas of benefits specification, provider payment, and performance monitoring. We found that the introduction and expansion of benefit packages for maternity, outpatient, and specialized services improved responsiveness to population needs and enhanced protection from financial hardship. However, access to service entitlements was limited by inadequate awareness of the covered services among providers and lack of service availability at contracted facilities. Provider payment reforms increased health facilities' access to funds, which enhanced service delivery, quality of care, and staff motivation. But delays and the perceived inadequacy of payment rates incentivized negative provider behavior, which limited access to care and exposed patients to out-of-pocket payments. We found that performance monitoring reforms improved the quality assurance capacity of the public insurer and enhanced patient safety, service utilization, and quality of care provided by facilities. Although health purchasing reforms have improved access, quality of care, and financial risk protection to some extent in Kenya, they should be aligned and implemented jointly rather than as individual interventions. Measures that policymakers might consider include strengthening communication of health benefits, timely and adequate payment of providers, and enhancing health facility autonomy over the revenues they generate.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":" ","pages":"2114173"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40375598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Strategic Health Purchasing in Nigeria: Exploring the Evidence on Health System and Service Delivery Improvements. 尼日利亚战略性医疗采购:探索改善卫生系统和服务提供的证据。

Health systems and reform Pub Date : 2022-03-01 DOI: 10.1080/23288604.2022.2111785

Obinna Onwujekwe, Chinyere Ojiugo Mbachu, Chinyere Okeke, Uchenna Ezenwaka, Daniel Ogbuabor, Charles Ezenduka

{"title":"Strategic Health Purchasing in Nigeria: Exploring the Evidence on Health System and Service Delivery Improvements.","authors":"Obinna Onwujekwe, Chinyere Ojiugo Mbachu, Chinyere Okeke, Uchenna Ezenwaka, Daniel Ogbuabor, Charles Ezenduka","doi":"10.1080/23288604.2022.2111785","DOIUrl":"https://doi.org/10.1080/23288604.2022.2111785","url":null,"abstract":"Well-functioning purchasing arrangements allocate pooled funds to health providers, and are expected to deliver efficient, effective, quality, equitable and responsive health services and advance progress toward universal health coverage (UHC). This paper explores how improvements in purchasing functions in three Nigerian schemes-the Formal Sector Social Health Insurance Program (FSSHIP), the Saving One Million Lives Program for Results (SOML PforR), and Enugu State's Free Maternal and Child Health Program (FMCHP)-may have contributed to better resource allocation, incentives for performance, greater accountability and improved service delivery. The paper uses a case-study approach, with data analyzed using the Strategic Health Purchasing Progress Tracking Framework. Data were collected through review of program documents and published research articles, and semi-structured interviews of 33 key informant interviews. Findings were triangulated within each case study across the multiple sources of information. Improvements in benefits specification and provider payment contributed to some service delivery improvements in all three schemes: higher satisfaction with the quality of care in FSSHIP; increased use of insecticide-treated nets; greater prevention of mother-to-child HIV transmission; expanded pentavalent-3 coverage in SOML PforR; and greater service utilization in FMCHP. Resource allocation to public health facilities was enhanced and lines of accountability were better defined. These scheme-level improvements have not translated to system change, because of the small amount of funding flowing through these schemes and the high level of health financing fragmentation. The institutionalization of strategic purchasing in Nigeria to advance UHC will require raising awareness among decision makers, strengthening purchasing agencies' capacity, and reducing fragmentation.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":" ","pages":"2111785"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40716834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

The Government Budget: An Overlooked Vehicle for Advancing Strategic Health Purchasing. 政府预算:一个被忽视的推进战略性医疗采购的工具。

Health systems and reform Pub Date : 2022-03-01 DOI: 10.1080/23288604.2022.2082020

Aloysius Ssennyonjo, Otieno Osoro, Freddie Ssengooba, Elizabeth Ekirapa-Kiracho, Chrispus Mayora, Richard Ssempala, Danielle Bloom

{"title":"The Government Budget: An Overlooked Vehicle for Advancing Strategic Health Purchasing.","authors":"Aloysius Ssennyonjo, Otieno Osoro, Freddie Ssengooba, Elizabeth Ekirapa-Kiracho, Chrispus Mayora, Richard Ssempala, Danielle Bloom","doi":"10.1080/23288604.2022.2082020","DOIUrl":"https://doi.org/10.1080/23288604.2022.2082020","url":null,"abstract":"The most effective way to finance universal health coverage (UHC) is through compulsory prepaid funds that flow through the government budget. Public funds-including on-budget donor resources-allow for pooling and allocation of resources to providers in a way that aligns with population health needs. This is particularly important for low-income settings with fiscal constraints. While much attention is paid to innovative sources of additional financing for UHC and to implementing strategic purchasing approaches, the government budget will continue to be the main source of health financing in most countries-and the most stable mechanism for channeling additional funds. The government budget should therefore be front and center on the strategic purchasing agenda. This commentary uses lessons from Tanzania and Uganda to demonstrate that more can be done to use the government budget as a vehicle for making health purchasing more strategic, across all phases of the budget cycle, and for making greater progress toward UHC. Actions need to be accompanied by measures to address bottlenecks in the public financial management system.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":" ","pages":"2082020"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40572615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

SPARC the Change: What the Strategic Purchasing Africa Resource Center Has Learned about Improving Strategic Health Purchasing in Africa. SPARC变革:战略采购非洲资源中心对改善非洲战略医疗采购的经验。

Health systems and reform Pub Date : 2022-03-01 DOI: 10.1080/23288604.2022.2149380

Cheryl Cashin, George Kimathi, Nathaniel Otoo, Danielle Bloom, Agnes Gatome-Munyua

{"title":"SPARC the Change: What the Strategic Purchasing Africa Resource Center Has Learned about Improving Strategic Health Purchasing in Africa.","authors":"Cheryl Cashin, George Kimathi, Nathaniel Otoo, Danielle Bloom, Agnes Gatome-Munyua","doi":"10.1080/23288604.2022.2149380","DOIUrl":"https://doi.org/10.1080/23288604.2022.2149380","url":null,"abstract":"Embodied in the goals of universal health coverage (UHC) are societal norms about ethics, equity, solidarity, and social justice. As African countries work toward UHC, it is important for their governments to use all available resources, knowledge, and networks to continue to bring this goal closer to reality for their populations. The Strategic Purchasing Africa Resource Center (SPARC) was established in 2018 as a \"go-to\" source of Africa-based expertise in strategic health purchasing, which is a critical policy tool for making more effective use of limited funds for UHC. SPARC facilitates collaboration among governments and research partners across Africa to fill gaps in knowledge on how to make progress on strategic purchasing. The cornerstone of this work has been the development and use of the Strategic Health Purchasing Progress Tracking Framework to garner insights from each country's efforts to make health purchasing more strategic. Application of the framework and subsequent dialogue within and between countries generated lessons on effective purchasing approaches that other countries can apply as they chart their own course to use strategic purchasing more effectively. These lessons include the need to clarify the roles of purchasing agencies, define explicit benefit packages as a precondition for other strategic purchasing functions, use contracting to set expectations, start simple with provider payment and avoid open-ended payment mechanisms, and use collaborative rather than punitive provider performance monitoring. SPARC has also facilitated learning on the \"how-to\" and practical steps countries can take to make progress on strategic purchasing to advance UHC.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"8 2","pages":"2149380"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10479708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0