Abstract Background Discussions of health system resilience and emergency management often highlight the importance coordination partnership across government with other stakeholders. However, both have been identified as areas requiring further research. This paper identifies characteristics enablers effective for preparedness response, drawing on experience from different countries a range shocks, including floods, drought, COVID-19. Methods The synthesises evidence set reports related to...

Abstract Background Over the last decades, universal health coverage (UHC) has been promoted in south-east Asia (SEA), where many countries still need to ensure adequate financial protection their populations. However, successful financing reforms involve complex interactions among a range of stakeholders, as well with context factors, including shocks and crises different nature. In this article, we examine recent Nepal, Thailand Indonesia, using political economy lens. The objective is...

Institutional arrangements of health systems and the incentives they set are increasingly recognized as critical to promote or hinder performance in sector. Looking at complex system interventions from an institutional perspective may contribute better understanding what paths processes that lead results such interventions. In this article, we propose analytical framework drawing new economics. This suggests seven dimensions look at: institutions, enforcement mechanisms, property rights,...

There is an acknowledged gap in the literature on impact of fee exemption policies health staff, and, conversely, implications staffing for exemption. This article draws from five research tools used to analyse changing worker and incentives post-war Sierra Leone document effects Free Health Care Initiative (FHCI) 2010 workers. Data were collected through review (57 documents fully reviewed, published grey); key informant interviews (23 with government, donors, NGO staff consultants);...

The financial remuneration of health workers (HWs) is a key concern to address human resources for challenges. In low-income settings, the exploration sources income available HWs, their determinants and livelihoods strategies that those remunerations entail are essential gain better understanding motivation effects on performance service provision. This even more relevant in setting such as DR Congo, characterized by inability state provide public services via well-supported financed...

In May 2006, the President of Burundi announced removal user fees in all health centres and hospitals for children under 5 women giving birth. As other studies also point out, policy was adopted extremely suddenly, without much reflection on its ultimate aims operational dimension implementation. From perspective a frontline manager, this paper provides descriptive case study abolition Muramvya District first-hand account effects sudden reform management district hospital. The analysis...

It is recognized that decisions taken in the early recovery period may affect development of health systems. Additionally, some suggest immediate post-conflict allow for opening a political 'window opportunity' reform. For these reasons, it useful to reflect on policy space exists this period, by what shaped, how are made, and their long-term implications. Examining trajectory its determinants can be helpful explore specific features policy-making environment. With aim, study looks at...

There is growing interest on the impact of performance-based financing (PBF) health workers' motivation and performance. However, literature so far tends to look at PBF payments in isolation, without reference overall remuneration workers. Taking case Sierra Leone, where was introduced 2011, this study investigates absolute relative contribution income explores their views bonuses, comparison interaction with other incomes.The based a mixed-methods research consisting survey an 8-week...

Results-based financing (RBF) has been introduced in many countries across Africa and a growing literature is building around the assessment of their impact. These studies are usually quantitative often silent on paths processes through which results achieved wider health system effects RBF. To address this gap, our study aims at exploring implementation an RBF pilot Benin, focusing verification results. The based action research carried out by authors involved as part agency supporting...

Abstract Communities of Practice (CoPs) are groups people that interact regularly to deepen their knowledge on a specific topic. Thanks information and communication technologies, CoPs can involve experts distributed across countries adopt ‘transnational’ membership. This has allowed the strategy be applied domains such as health policy with global perspective. represent potentially valuable tool for producing sharing explicit knowledge, well tacit implementation practices. They may also...

Performance-based financing (PBF) has acquired increased prominence as a means of reforming health system purchasing structures in low-income and middle-income countries. A number impact evaluations have noted that PBF often produces mixed heterogeneous effects. Still, little systematic effort been channelled towards understanding what causes such heterogeneity, including looking more closely at implementation processes.

Human resources for health represent an essential component of systems and play a key role to accelerate progress towards universal coverage. Many countries in sub-Saharan Africa face challenges regarding the availability, distribution performance workers, which could be part addressed by providing effective financial incentives. Based on overview existing literature, paper highlights gaps research low-income exploring different components workers' incomes. It then proposes novel approach...

Few studies look at policy making in the health sector aftermath of a conflict or crisis and even fewer specifically focus on Human Resources for Health, which is critical domain performance. The main objective article to shed light patterns drivers post-conflict policy-making. In particular, we explore whether post -conflict period offers increased chances opening 'windows opportunity' change reform potential reset systems.This uses comparative analysis framework. It based qualitative data,...

Human resources for health are self-evidently critical to running a service and system. There is, however, wider set of social issues which is more rarely considered. One area hinted at in literature, particularly on fragile conflict-affected states, but examined detail, the contribution staff may or do play relation state-building processes. This article aims explore that relationship, developing conceptual framework understand what linkages might exist looking empirical evidence literature...

Results-Based Financing (RBF) has proliferated in health sectors of low and middle income countries, especially fragile conflict-affected ones, been presented as a way reforming strengthening strategic purchasing. However, few studies have empirically examined how RBF impacts on care purchasing these settings. This article examines the effects several programmes functions three post-conflict settings: Uganda, Zimbabwe Democratic Republic Congo (DRC) over past decade. The is based documentary...

Performance based financing (PBF) has been increasingly implemented across low and middle-income countries, including in fragile humanitarian settings, which present specific features likely to require adaptation influence implementation of any health programme. However, the literature surprisingly thin discussion how PBF adapted different contexts, turn contexts may PBF. With case studies from three settings (northern Nigeria, Central African Republic South Kivu Democratic Congo), we...

Since 2000, results based financing (RBF) has proliferated in health sectors Africa particular, including fragile and conflict affected settings (FCAS) there is a growing but still contested literature about its relevance effectiveness. Less examined are the political economy factors behind adoption of RBF policy, as well shifts influence resources which may bring about. In this article, we examine these two topics, focusing on Zimbabwe, rolled out nationwide system since 2011, with external...

As performance-based financing (PBF) has been increasingly implemented in low-income countries, a growing literature developed, assessing its effectiveness and, more recently, focussing on the political dynamics of PBF introduction and implementation. This study contributes to latter body by exploring decision-making processes Sierra Leone during 2010-2017 period. presents an interesting case because 'start-stop-start' trajectory PBF.The qualitative is based document review 25 key informant...

The need for evidence-based practice calls research focussing not only on the effectiveness of interventions and their translation into policies, but also implementation processes factors influencing them, in particular complex health system policies. In this paper, we use lens one system's 'building blocks', human resources (HRH), to examine official policies HRH incentives emergence informal practices three districts Sierra Leone. Our mixed-methods draws mostly from 18 key informant...

Abstract Background There is often collateral damage to health systems during epidemics, affecting women and girls the most, with reduced access non-outbreak related services, particularly in humanitarian settings. This rapid case study examines sexual reproductive (SRH) services Democratic Republic of Congo when COVID-19 hit, towards end an Ebola Virus Disease (EVD) outbreak, a context protracted insecurity. Methods draws on quantitative analysis routine data from four zones, document...

Abstract Background The Pradhan Mantri Jan Arogya Yojana (PM-JAY), a publicly funded health insurance scheme, was launched in India September 2018 to provide financial access services for poor Indians. PM-JAY design enables state-level program adaptations facilitate implementation decentralized space. This study examines the competency, organizational, and leadership approaches affecting three contextually different Indian states. Methods We used framework on drivers (competency, leadership)...

Abstract Background Due to the weaknesses of public health system and its low reach, especially in border areas, provision services by non-state actors (NSAs) has historically played an important role Myanmar. NSAs include local international NGOs civil society organisations (CSOs), but also Ethnic Health Organisations (EHOs) as well private (for profit) sector. This study aims understand changing shifting political environment Myanmar between 2010 2022, explore their contribution...