Countdown to 2015 country case studies: systematic tools to address the “black box” of health systems and policy assessment
Abstract Background Evaluating health systems and policy (HSP) change and implementation is critical in understanding reproductive, maternal, newborn and child health (RMNCH) progress within and across countries. Whilst data for health outcomes, coverage and equity have advanced in the last decade,...
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2016-09-01
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Online Access: | http://link.springer.com/article/10.1186/s12889-016-3402-5 |
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English |
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Article |
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DOAJ |
author |
Neha S. Singh Luis Huicho Hoviyeh Afnan-Holmes Theopista John Allisyn C. Moran Tim Colbourn Chris Grundy Zoe Matthews Blerta Maliqi Matthews Mathai Bernadette Daelmans Jennifer Requejo Joy E. Lawn On behalf of the Countdown to 2015 Health Systems and Policies Technical Working Group |
spellingShingle |
Neha S. Singh Luis Huicho Hoviyeh Afnan-Holmes Theopista John Allisyn C. Moran Tim Colbourn Chris Grundy Zoe Matthews Blerta Maliqi Matthews Mathai Bernadette Daelmans Jennifer Requejo Joy E. Lawn On behalf of the Countdown to 2015 Health Systems and Policies Technical Working Group Countdown to 2015 country case studies: systematic tools to address the “black box” of health systems and policy assessment BMC Public Health Policy analysis Health systems Reproductive health Newborn health Maternal health Child health |
author_facet |
Neha S. Singh Luis Huicho Hoviyeh Afnan-Holmes Theopista John Allisyn C. Moran Tim Colbourn Chris Grundy Zoe Matthews Blerta Maliqi Matthews Mathai Bernadette Daelmans Jennifer Requejo Joy E. Lawn On behalf of the Countdown to 2015 Health Systems and Policies Technical Working Group |
author_sort |
Neha S. Singh |
title |
Countdown to 2015 country case studies: systematic tools to address the “black box” of health systems and policy assessment |
title_short |
Countdown to 2015 country case studies: systematic tools to address the “black box” of health systems and policy assessment |
title_full |
Countdown to 2015 country case studies: systematic tools to address the “black box” of health systems and policy assessment |
title_fullStr |
Countdown to 2015 country case studies: systematic tools to address the “black box” of health systems and policy assessment |
title_full_unstemmed |
Countdown to 2015 country case studies: systematic tools to address the “black box” of health systems and policy assessment |
title_sort |
countdown to 2015 country case studies: systematic tools to address the “black box” of health systems and policy assessment |
publisher |
BMC |
series |
BMC Public Health |
issn |
1471-2458 |
publishDate |
2016-09-01 |
description |
Abstract Background Evaluating health systems and policy (HSP) change and implementation is critical in understanding reproductive, maternal, newborn and child health (RMNCH) progress within and across countries. Whilst data for health outcomes, coverage and equity have advanced in the last decade, comparable analyses of HSP changes are lacking. We present a set of novel tools developed by Countdown to 2015 (Countdown) to systematically analyse and describe HSP change for RMNCH indicators, enabling multi-country comparisons. Methods International experts worked with eight country teams to develop HSP tools via mixed methods. These tools assess RMNCH change over time (e.g. 1990–2015) and include: (i) Policy and Programme Timeline Tool (depicting change according to level of policy); (ii) Health Policy Tracer Indicators Dashboard (showing 11 selected RMNCH policies over time); (iii) Health Systems Tracer Indicators Dashboard (showing four selected systems indicators over time); and (iv) Programme implementation assessment. To illustrate these tools, we present results from Tanzania and Peru, two of eight Countdown case studies. Results The Policy and Programme Timeline tool shows that Tanzania’s RMNCH environment is complex, with increased funding and programmes for child survival, particularly primary-care implementation. Maternal health was prioritised since mid-1990s, yet with variable programme implementation, mainly targeting facilities. Newborn health only received attention since 2005, yet is rapidly scaling-up interventions at facility- and community-levels. Reproductive health lost momentum, with re-investment since 2010. Contrastingly, Peru moved from standalone to integrated RMNCH programme implementation, combined with multi-sectoral, anti-poverty strategies. The HSP Tracer Indicators Dashboards show that Peru has adopted nine of 11 policy tracer indicators and Tanzania has adopted seven. Peru costed national RMNCH plans pre-2000, whereas Tanzania developed a national RMNCH plan in 2006 but only costed the reproductive health component. Both countries included all lifesaving RMNCH commodities on their essential medicines lists. Peru has twice the health worker density of Tanzania (15.4 vs. 7.1/10,000 population, respectively), although both are below the 22.8 WHO minimum threshold. Conclusions These are the first HSP tools using mixed methods to systematically analyse and describe RMNCH changes within and across countries, important in informing accelerated progress for ending preventable maternal, newborn and child mortality in the post-2015 era. |
topic |
Policy analysis Health systems Reproductive health Newborn health Maternal health Child health |
url |
http://link.springer.com/article/10.1186/s12889-016-3402-5 |
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doaj-187b4f0b71e94ac5ac106525f4428a522020-11-24T22:21:49ZengBMCBMC Public Health1471-24582016-09-0116S2516610.1186/s12889-016-3402-5Countdown to 2015 country case studies: systematic tools to address the “black box” of health systems and policy assessmentNeha S. Singh0Luis Huicho1Hoviyeh Afnan-Holmes2Theopista John3Allisyn C. Moran4Tim Colbourn5Chris Grundy6Zoe Matthews7Blerta Maliqi8Matthews Mathai9Bernadette Daelmans10Jennifer Requejo11Joy E. Lawn12On behalf of the Countdown to 2015 Health Systems and Policies Technical Working GroupCentre for Maternal, Adolescent, Reproductive and Child Health, London School of Hygiene & Tropical MedicineCentro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano HerediaIndependent consultantWorld Health OrganisationUS Agency for International Development, Bureau of Global Health, Office of Health, Infectious Disease and NutritionInstitute for Global Health, University College LondonCentre for Maternal, Adolescent, Reproductive and Child Health, London School of Hygiene & Tropical MedicineDivision of Social Statistics and Demography, University of SouthamptonDepartment of Maternal, Newborn, Child and Adolescent Health, World Health OrganisationDepartment of Maternal, Newborn, Child and Adolescent Health, World Health OrganisationDepartment of Maternal, Newborn, Child and Adolescent Health, World Health OrganisationPartnership for Maternal, Newborn & Child HealthCentre for Maternal, Adolescent, Reproductive and Child Health, London School of Hygiene & Tropical MedicineAbstract Background Evaluating health systems and policy (HSP) change and implementation is critical in understanding reproductive, maternal, newborn and child health (RMNCH) progress within and across countries. Whilst data for health outcomes, coverage and equity have advanced in the last decade, comparable analyses of HSP changes are lacking. We present a set of novel tools developed by Countdown to 2015 (Countdown) to systematically analyse and describe HSP change for RMNCH indicators, enabling multi-country comparisons. Methods International experts worked with eight country teams to develop HSP tools via mixed methods. These tools assess RMNCH change over time (e.g. 1990–2015) and include: (i) Policy and Programme Timeline Tool (depicting change according to level of policy); (ii) Health Policy Tracer Indicators Dashboard (showing 11 selected RMNCH policies over time); (iii) Health Systems Tracer Indicators Dashboard (showing four selected systems indicators over time); and (iv) Programme implementation assessment. To illustrate these tools, we present results from Tanzania and Peru, two of eight Countdown case studies. Results The Policy and Programme Timeline tool shows that Tanzania’s RMNCH environment is complex, with increased funding and programmes for child survival, particularly primary-care implementation. Maternal health was prioritised since mid-1990s, yet with variable programme implementation, mainly targeting facilities. Newborn health only received attention since 2005, yet is rapidly scaling-up interventions at facility- and community-levels. Reproductive health lost momentum, with re-investment since 2010. Contrastingly, Peru moved from standalone to integrated RMNCH programme implementation, combined with multi-sectoral, anti-poverty strategies. The HSP Tracer Indicators Dashboards show that Peru has adopted nine of 11 policy tracer indicators and Tanzania has adopted seven. Peru costed national RMNCH plans pre-2000, whereas Tanzania developed a national RMNCH plan in 2006 but only costed the reproductive health component. Both countries included all lifesaving RMNCH commodities on their essential medicines lists. Peru has twice the health worker density of Tanzania (15.4 vs. 7.1/10,000 population, respectively), although both are below the 22.8 WHO minimum threshold. Conclusions These are the first HSP tools using mixed methods to systematically analyse and describe RMNCH changes within and across countries, important in informing accelerated progress for ending preventable maternal, newborn and child mortality in the post-2015 era.http://link.springer.com/article/10.1186/s12889-016-3402-5Policy analysisHealth systemsReproductive healthNewborn healthMaternal healthChild health |