The policy capacity framework offers relevant analytical ideas that can be mobilized for health s... more The policy capacity framework offers relevant analytical ideas that can be mobilized for health system strengthening. However, the employment of this framework in the health field constitutes a relevant interdisciplinary gap in knowledge. This themed issue explores the relationships between the policy capacity framework and health system strengthening, in a multidimensional and interdisciplinary way, in high-income and low–middle-income countries. This introduction unpacks the dynamic interrelationships between the policy capacity framework and health system strengthening, bringing together common and distinct elements from both fields and summarizing possible relationships between them. The analysis shows that both fields together can increase our knowledge on health policies and system’s critical themes and reforms. This challenge could be followed by exploring the convergences between them, as far as concepts/themes (types of capacities and other themes) and levels of analysis ar...
This paper presents a case example from China, where detailed deliberations were instrumental in ... more This paper presents a case example from China, where detailed deliberations were instrumental in bringing together national and subnational managers to tailor implementation protocols for neonatal care strategies at provincial and county levels. The China National Health Development Research Center (CNHDRC) organised deliberations to support the formulation of strategies for improving early essential neonatal care for rural areas. The aim was to help counties, the lowest level jurisdiction in China, learn what could work locally, and to help provinces and the national government learn what should inform national policy and be disseminated widely in China’s decentralised health system. It became clear that central-level stakeholders needed to learn how to help counties support the pilots. CNHDRC staff, national-level experts and academics visited pilot provinces and counties to discuss local policies, initiatives and challenges (including with patients), build a common understanding ...
The concept of policy capacity is often used to explain the success or failure of governments or ... more The concept of policy capacity is often used to explain the success or failure of governments or countries in conceiving of, developing, and implementing policies, but is often poorly systematised. Wu et al provide a framework for understanding types of policy capacity, arguing that three kinds of capacity, distributed across policy systems, are needed for effective implementation. This paper applies that framework to a discussion of China, a country that has been managing a fundamental transformation since at least the late 1970s, which has underpinned the country’s growth and development. The paper focuses on a subset of China’s reforms – reforms to the healthcare system since the 1990s. Discussion of policy capacity shows (1) that policy capacity is dynamic and adaptive, in response to changing challenges due to rapid transformation in the country; (2) that the development and distribution of capacities has, overall, been government-directed, with strong research and analytical s...
Health is now recognized as a driver of economic development. Healthy people are more productive,... more Health is now recognized as a driver of economic development. Healthy people are more productive, have higher average incomes, spend less on healthcare, and create savings that are an important source of economic investment. Health, particularly in the early years of life, also contributes to other forms of human capital, such as cognitive ability and higher educational achievement. The importance of health in human capital and economic development makes investment in health critical. In recognition of this, in 2015, the UN General Assembly adopted the 2030 Agenda for Sustainable Development; health is the focal point of Sustainable Development Goal 3 (SDG 3): “To ensure healthy lives and promote wellbeing for all at all ages.” Because the determinants of health include factors beyond coverage of health services, achieving SDG 3 will depend on progress in poverty reduction, education, nutrition, gender equality, clean water, sanitation, and transportation, among others. The UN resol...
will require substantial increases in health spending and the proportion funded through taxation ... more will require substantial increases in health spending and the proportion funded through taxation or social insurance to make health care affordable for all. Not only will institutions need to be established to ensure sustainable arrangements for social finance, it will also be vital to ensure that health financing is resilient to economic and other shocks if Global Goal 3 is to be realised. This presents a major challenge in Africa, where an economic downturn is projected in a number of resource-dependent countries, such as Mozambique and Guinea Bissau and where countries such as Sierra Leone have weakened health systems. The response to these challenges by governments and development partners, will have important effects on how well people, and the health services on which they rely, cope in the short term and longer-term evolution of health coverage.
This is a Free Book available to download from the publisher. This new collection draws on four b... more This is a Free Book available to download from the publisher. This new collection draws on four books in the series, together addressing three themes central to understanding how pathways to sustainability emerge in response to health and disease challenges. The three themes are Social justice (who wins or loses from disease and how health policy is focused), Politics (how health and disease responses are framed, both locally and internationally) and Governance (how health policies are defined, and how health technologies are regulated and controlled)
In July 2017, IDS hosted a workshop on ‘Unpicking Power and Politics for Transformative Change: T... more In July 2017, IDS hosted a workshop on ‘Unpicking Power and Politics for Transformative Change: Towards Accountability for Health Equity’, with the aim of generating dialogue and mutual learning among activists, researchers, policymakers, and funders working towards more equitable health systems and a commitment to Universal Health Coverage (UHC). This issue of the IDS Bulletin is based around three principal themes that emerged from the workshop as needing particular attention. First, the nature of accountability politics ‘in time’ and the cyclical aspects of efforts towards accountability for health equity. Second, the contested politics of ‘naming’ and measuring accountability, and the intersecting dimensions of marginalisation and exclusion that are missing from current debates. Third, the shifting nature of power in global health and new configurations of health actors, social contracts, and the role of technology. For the first time in IDS Bulletin history, themes are explored...
BACKGROUND The rapid growth of technology and its use as development solutions have generated muc... more BACKGROUND The rapid growth of technology and its use as development solutions have generated much interest in eHealth, globally. In line with global trends, Bangladesh too is integrating technology into its health system to address disparities. Strong political endorsement and uptake of digital platforms by the government has influenced the rapid proliferation of such initiatives in the country. This paper examines the equity implications of eHealth and mHealth considering who use electronic devices to access health information and services and why, in Bangladesh. OBJECTIVE To understand how access to healthcare through electronic means (eHealth and/or mHealth) is affected by socio-demographic determinants (age, gender, education, socioeconomic status, personal and household ownership of mobile phone) in a semi-urban community in Bangladesh. METHODS A cross-sectional survey of 854 households (between October 2013 and February 2014) and 20 focus group discussions (between February t...
The WHO launched a Global Action Plan on antimicrobial resistance (AMR) in 2015. World leaders in... more The WHO launched a Global Action Plan on antimicrobial resistance (AMR) in 2015. World leaders in the G7, G20 and the UN General Assembly have declared AMR to be a global crisis. World leaders have also adopted universal health coverage (UHC) as a key target under the sustainable development goals. This paper argues that neither initiative is likely to succeed in isolation from the other and that the policy goals should be to both provide access to appropriate antimicrobial treatment and reduce the risk of the emergence and spread of resistance by taking a systems approach. It focuses on outpatient treatment of human infections and identifies a number of interventions that would be needed to achieve these policy goals. It then shows how a strategy for achieving key attributes of a health system for UHC can take into account the need to address AMR as part of a UHC strategy in any country. It concludes with a list of recommended priority actions for integrating initiatives on AMR and...
The policy capacity framework offers relevant analytical ideas that can be mobilized for health s... more The policy capacity framework offers relevant analytical ideas that can be mobilized for health system strengthening. However, the employment of this framework in the health field constitutes a relevant interdisciplinary gap in knowledge. This themed issue explores the relationships between the policy capacity framework and health system strengthening, in a multidimensional and interdisciplinary way, in high-income and low–middle-income countries. This introduction unpacks the dynamic interrelationships between the policy capacity framework and health system strengthening, bringing together common and distinct elements from both fields and summarizing possible relationships between them. The analysis shows that both fields together can increase our knowledge on health policies and system’s critical themes and reforms. This challenge could be followed by exploring the convergences between them, as far as concepts/themes (types of capacities and other themes) and levels of analysis ar...
This paper presents a case example from China, where detailed deliberations were instrumental in ... more This paper presents a case example from China, where detailed deliberations were instrumental in bringing together national and subnational managers to tailor implementation protocols for neonatal care strategies at provincial and county levels. The China National Health Development Research Center (CNHDRC) organised deliberations to support the formulation of strategies for improving early essential neonatal care for rural areas. The aim was to help counties, the lowest level jurisdiction in China, learn what could work locally, and to help provinces and the national government learn what should inform national policy and be disseminated widely in China’s decentralised health system. It became clear that central-level stakeholders needed to learn how to help counties support the pilots. CNHDRC staff, national-level experts and academics visited pilot provinces and counties to discuss local policies, initiatives and challenges (including with patients), build a common understanding ...
The concept of policy capacity is often used to explain the success or failure of governments or ... more The concept of policy capacity is often used to explain the success or failure of governments or countries in conceiving of, developing, and implementing policies, but is often poorly systematised. Wu et al provide a framework for understanding types of policy capacity, arguing that three kinds of capacity, distributed across policy systems, are needed for effective implementation. This paper applies that framework to a discussion of China, a country that has been managing a fundamental transformation since at least the late 1970s, which has underpinned the country’s growth and development. The paper focuses on a subset of China’s reforms – reforms to the healthcare system since the 1990s. Discussion of policy capacity shows (1) that policy capacity is dynamic and adaptive, in response to changing challenges due to rapid transformation in the country; (2) that the development and distribution of capacities has, overall, been government-directed, with strong research and analytical s...
Health is now recognized as a driver of economic development. Healthy people are more productive,... more Health is now recognized as a driver of economic development. Healthy people are more productive, have higher average incomes, spend less on healthcare, and create savings that are an important source of economic investment. Health, particularly in the early years of life, also contributes to other forms of human capital, such as cognitive ability and higher educational achievement. The importance of health in human capital and economic development makes investment in health critical. In recognition of this, in 2015, the UN General Assembly adopted the 2030 Agenda for Sustainable Development; health is the focal point of Sustainable Development Goal 3 (SDG 3): “To ensure healthy lives and promote wellbeing for all at all ages.” Because the determinants of health include factors beyond coverage of health services, achieving SDG 3 will depend on progress in poverty reduction, education, nutrition, gender equality, clean water, sanitation, and transportation, among others. The UN resol...
will require substantial increases in health spending and the proportion funded through taxation ... more will require substantial increases in health spending and the proportion funded through taxation or social insurance to make health care affordable for all. Not only will institutions need to be established to ensure sustainable arrangements for social finance, it will also be vital to ensure that health financing is resilient to economic and other shocks if Global Goal 3 is to be realised. This presents a major challenge in Africa, where an economic downturn is projected in a number of resource-dependent countries, such as Mozambique and Guinea Bissau and where countries such as Sierra Leone have weakened health systems. The response to these challenges by governments and development partners, will have important effects on how well people, and the health services on which they rely, cope in the short term and longer-term evolution of health coverage.
This is a Free Book available to download from the publisher. This new collection draws on four b... more This is a Free Book available to download from the publisher. This new collection draws on four books in the series, together addressing three themes central to understanding how pathways to sustainability emerge in response to health and disease challenges. The three themes are Social justice (who wins or loses from disease and how health policy is focused), Politics (how health and disease responses are framed, both locally and internationally) and Governance (how health policies are defined, and how health technologies are regulated and controlled)
In July 2017, IDS hosted a workshop on ‘Unpicking Power and Politics for Transformative Change: T... more In July 2017, IDS hosted a workshop on ‘Unpicking Power and Politics for Transformative Change: Towards Accountability for Health Equity’, with the aim of generating dialogue and mutual learning among activists, researchers, policymakers, and funders working towards more equitable health systems and a commitment to Universal Health Coverage (UHC). This issue of the IDS Bulletin is based around three principal themes that emerged from the workshop as needing particular attention. First, the nature of accountability politics ‘in time’ and the cyclical aspects of efforts towards accountability for health equity. Second, the contested politics of ‘naming’ and measuring accountability, and the intersecting dimensions of marginalisation and exclusion that are missing from current debates. Third, the shifting nature of power in global health and new configurations of health actors, social contracts, and the role of technology. For the first time in IDS Bulletin history, themes are explored...
BACKGROUND The rapid growth of technology and its use as development solutions have generated muc... more BACKGROUND The rapid growth of technology and its use as development solutions have generated much interest in eHealth, globally. In line with global trends, Bangladesh too is integrating technology into its health system to address disparities. Strong political endorsement and uptake of digital platforms by the government has influenced the rapid proliferation of such initiatives in the country. This paper examines the equity implications of eHealth and mHealth considering who use electronic devices to access health information and services and why, in Bangladesh. OBJECTIVE To understand how access to healthcare through electronic means (eHealth and/or mHealth) is affected by socio-demographic determinants (age, gender, education, socioeconomic status, personal and household ownership of mobile phone) in a semi-urban community in Bangladesh. METHODS A cross-sectional survey of 854 households (between October 2013 and February 2014) and 20 focus group discussions (between February t...
The WHO launched a Global Action Plan on antimicrobial resistance (AMR) in 2015. World leaders in... more The WHO launched a Global Action Plan on antimicrobial resistance (AMR) in 2015. World leaders in the G7, G20 and the UN General Assembly have declared AMR to be a global crisis. World leaders have also adopted universal health coverage (UHC) as a key target under the sustainable development goals. This paper argues that neither initiative is likely to succeed in isolation from the other and that the policy goals should be to both provide access to appropriate antimicrobial treatment and reduce the risk of the emergence and spread of resistance by taking a systems approach. It focuses on outpatient treatment of human infections and identifies a number of interventions that would be needed to achieve these policy goals. It then shows how a strategy for achieving key attributes of a health system for UHC can take into account the need to address AMR as part of a UHC strategy in any country. It concludes with a list of recommended priority actions for integrating initiatives on AMR and...
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