There are rare moments in the global health calendar when those with an eye on the past are given space to speak in the present. Over the last decade working in this field, I have mostly kept my historical leanings secret and worn my anthropologist ‘hat’ instead. Who wants to think about the detritus of the past when there is so much pressure to move as quickly as possible towards the ‘next big thing’? This year, however, the past is inescapable. We are on the eve of marking the anniversary of the Alma Ata “Health for All by 2000” declaration. We are in a period defined by a renewed global commitment to achieve Universal Health Coverage by 2030 and at IDS we have just launched the new IDS Bulletin Accountability for Health Equity: Galvanising a Movement for Universal Health Coverage. Given that inequities in health have stagnated, and in some cases worsened, over these last forty years, we need to think more critically about what UHC2030 means in light of past efforts and the nature of change over time.
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FHS partners from Ethiopia, Uganda, India and Liberia attended the recent FHS “Issue Briefs: A Knowledge translation tool for evidence-informed decision-making” workshop held at IIFPHC-E from March 26-29, 2018.
FHS partners alongside other researchers from Ethiopian research institutes and universities, and practitioners from the Federal Ministry of Health in Ethiopia gathered to take a deep dive into the art and science of writing an Issue Brief.
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Manasee Mishra, IIHMR Kolkata and Future Health Systems, writes that if we are to truly 'leave no one behind' and achieve Universal Health Coverage (UHC), then we must recognise and respond to the compounding effects of multiple social identities that compound exclusion, discrimination and marginalisation.
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For World Health Day 2018, Elizabeth Ekirapa-Kiracho, Makerere University School of Public Health, Uganda, calls on Africans to hold their politicians accountable for meeting the health care needs of their people, and delivering on the commitments they made in the Abuja Declaration 17 years ago.
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Helping improve health systems for disadvantaged and marginalised populations is an important value motivating health systems research in low and middle-income countries (LMICs). However, simply undertaking health systems research in LMICs does not necessarily generate the knowledge needed to achieve that goal.
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Quite a lot has changed in the last 40 years, right? And yet, four decades since the 1978 signing of the international Alma Ata declaration in Almaty, Kazakhstan, meeting the essential health needs of people through primary health care has once again been highlighted as the key to the attainment of Health for All by a ‘new’ global movement.
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Forty years after the well-intentioned Alma Ata Declaration (1978), ‘Health for All’ remains a distant goal. This is particularly so for populations living in vulnerable parts of the world – conflict areas, prone to natural disasters, or geographically remote and vulnerable areas such as the Sundarbans in India. How does one, in the era of the SDGs ensure that goal #3 is achieved for the most marginalized? This blog takes us to the riverine areas of the Sundarbans in India to understand better the contextual factors which inhibit the provision, and access to health services for the people living there.
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On 29th November 2017, Sierra Leone Urban Research Centre (SLURC) held a one day workshop to highlight some of the challenges, threats and drivers of health risks in urban Sierra Leone. The workshop brought together stakeholders drawn from central government ministries and agencies, the Freetown City Council, health NGOs, CBOs and community federations to discuss pertinent issues from the on-going scoping study report and to identifying what needs to be prioritized for SLURC’s Future Health Systems (FHS) research agenda on urban health.
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Caroline Namugwere (not real name) is a 27 year old disabled woman and resident of Kibuku District in Eastern Uganda. Her pregnancy experience was laden with challenges right from attending antenatal clinic appointments to delivery. Inquiry into the plight of the marginalised is part of what the Community Score Cards study of Makerere University School of Public Health in partnership with the Future Health Systems Research Consortium intends to explore over the coming months in Kibuku District in Eastern Uganda. Specific to the case of Caroline and other marginalised groups, the following research question is being pursued: To what extent does a community scorecard process incorporate and address the maternal and newborn service related needs of marginalized populations?
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We had three days. That was it. We had three days: to gather, to share ideas and experiences, to make new connections, to strengthen existing ones, and to wrestle with the conceptual beast that is “accountability.” The aim? To bring sharp minds, creative problem-solvers and pragmatic innovators together under one roof so that we might get a few steps closer to our common goal of greater health equity. Did it work? Yes. With caveats. You can be the judge.
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The term ‘BRICS’ was coined to reflect a changing world, in which a number of large, emerging economies were starting to play a greater role in world economic affairs. Terms such as this reflect changing global realities, but also have the potential to shape those realities. The jury is still out on how far China’s ‘Belt and Road Initiative’ (BRI) will reshape the way we see the world. The view of blog post authors Lewsi Husain and Gerry Bloom is that it will have a significant impact in many areas, one of which is advancing cooperation for global health. At a time of retrenchment and reorientation in developed economies’ assistance, how China, existing donors and health agencies learn to work together will have an important impact on global health outcomes and may provide learning on how to collaborate on other, more contentious, issues.
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Stefan Peterson, Chief of Health, UNICEF, highlights the contribution of a maternal and newborn health implementation project in Uganda led by Future Health Systems partner, the Makerere School of Public Health, to improvements in early antenatel care attendance, facility deliveries, newborn care practices, birth preparedness, and awareness of obstetric danger signs.
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By Ligia Paina, FHS Researcher
What happens when you bring 80+ social activists, anthropologists, health systems researchers and policy makers together for a three day workshop and ask them to further the collective understanding of accountability and its role in health equity?
I am going to leave that question for the team from the Institute of Development Studies that hosted the workshop, but here I wanted to share some reflections on what was a fascinating event.
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Last week, between 80-90 researchers, practitioners, advocates and policymakers gathered for a three-day workshop organised by the IDS Accountability for Health Equity programme. Entitled Unpicking Power and Politics for Transformative Change: Towards Accountability for Health Equity, the event was hosted in collaboration with Unequal Voices, Future Health Systems, the Open Society Foundations, the Impact Initiative, and Health Systems Global. In this blog, Tom Barker and Karine Gatellier share their reflections from the event.
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In 1895, poet Joseph Malins described an ill-starred town shadowed by a cliff. Citizens would regularly tumble off the cliff, so the town mercifully pays for a public ambulance. The poet berates the town for not building a fence at the rim of the cliff. As the G20 come together this July in Hamburg, they should take heed and learn the lessons from this fenceless town. Addressing global health security challenges like pandemics and resistance to antibiotics requires not just an ambulance, but a fence too.
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Makerere University School of Public Health recently concluded a four-year intervention aimed at sustainably improving maternal and neonatal health outcomes, implemented in the Eastern Ugandan districts of Kamuli, Pallisa and Kibuku. The intervention - the Maternal and Neonatal Implementation for Equitable Systems Study or MANIFEST - employed a participatory action research approach that has been lauded for increasing sustainability chances. This blog post examines lessons learned from the performance review meetings which were part of the approach.
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“Scaling up” is considered as a pertinent and scientific pathway recognized by academia and policy makers to reduce inequalities, to achieve the Sustainable Development Goals (SDGs), and for universal health coverage. To build upon and learn from the longstanding partnership between Bangladesh Rural Advancement Committee (BRAC), International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B), and the Institute of Development Studies (IDS), a two day conference was held on 7 -8 February in Dhaka, Bangladesh to share diverse perspectives, pathways and learnings from contextual settings to achieve successful scaling up of interventions and collaborations. The conference, in addition to throwing light on the pathways of scaling up of programs through our learnings, also acted as a potential accelerator for collaboration. This blog post shares five critical reflections from the conference mentioned below.
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This International Women’s Day, March 8 2017, RinGs consider the relationship between women’s health and gender inequity and identify key points for health practitioners and researchers to consider.
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In India, there is a growing interest in partnership driven innovative service delivery models for providing health services to the poor. Consequently, the state and central governments in India have initiated 226 innovative programs of which 43 are through public private partnerships (PPPs). In spite of this interest in PPPs, very few programs have been scaled up to reach a wider population.On one hand, PPPs are lauded as an innovative model for service delivery and multiplicative scale-up that includes multiple actors. On the other hand, it is argued that factors such as inadequate funding, changing political context and PPP modalities like tendering and contracts limit the resources available for development and scale-up of innovations. But the fundamental question is – how can partnerships based on the premise of collaborative functioning that leverages each other’s strengths foster innovative solutions for local problems and drive them to scale?
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How sustainable is your intervention? If someone wanted to replicate it, how easy would it be? What happens when the study ends? Will the communities be able to continue with this initiative after the implementers have gone? Ayub Kakaire, FHS PIRU Officer for Uganda, blogs about what working on the Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study has taught him about how to ensure an intervention is sustainable.
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