Tetui M, Coe A-B, Hurtig A-H, Bennett S, Kiwanuka SN, George A and Ekirapa Kiracho E (2017) A participatory action research approach to strengthening health managers’ capacity at district level in Eastern Uganda, Health Research Policy and Systems, 15(Suppl 2):110, DOI: 10.1186/s12961-017-0273-x
Many approaches to improving health managers’ capacity in poor countries, particularly those pursued by external agencies, employ non-participatory approaches and often seek to circumvent (rather than strengthen) weak public management structures. This limits opportunities for strengthening local health managers’ capacity, improving resource utilisation and enhancing service delivery. This study explored the contribution of a participatory action research approach to strengthening health managers’ capacity in Eastern Uganda.
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Paina L, Wilkinson A, Tetui M, Ekirapa-Kiracho E, Barman D, Ahmed T, Mahmood SS, Bloom G, Knezovich J, George A and Bennett S (2017) Using Theories of Change to inform implementation of health systems research and innovation: experiences of Future Health Systems consortium partners in Bangladesh, India and Uganda, Health Research Policy and Systems, 15(Suppl 2):109, DOI: 10.1186/s12961-017-0272-y
The Theory of Change (ToC) is a management and evaluation tool supporting critical thinking in the design, implementation and evaluation of development programmes. We document the experience of Future Health Systems (FHS) Consortium research teams in Bangladesh, India and Uganda with using ToC. We seek to understand how and why ToCs were applied and to clarify how they facilitate the implementation of iterative intervention designs and stakeholder engagement in health systems research and strengthening.
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Bennett S, Mahmood SS, Edward A, Tetui M and Ekirapa-Kiracho E (2017) Strengthening scaling up through learning from implementation: comparing experiences from Afghanistan, Bangladesh and Uganda, Health Research Policy and Systems, 15(Suppl 2):108, DOI: 10.1186/s12961-017-0270-0
Many effective innovations and interventions are never effectively scaled up. Implementation research (IR) has the promise of supporting scale-up through enabling rapid learning about the intervention and its fit with the context in which it is implemented. We integrate conceptual frameworks addressing different dimensions of scaling up (specifically, the attributes of the service or innovation being scaled, the actors involved, the context, and the scale-up strategy) and questions commonly addressed by IR (concerning acceptability, appropriateness, adoption, feasibility, fidelity to original design, implementation costs, coverage and sustainability) to explore how IR can support scale-up.
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Future Health Systems research into empowering communities to demand and shape health services has informed the development of a WHO strategy on service delivery. The strategy reflects a paradigm shift towards an increased emphasis on preventive public health, as well as curative strategies, to address current and future health challenges.
Glandon D, Paina L, Alonge O, Peters DH and Bennett S (2017) 10 Best resources for community engagement in implementation research, Health Policy and Planning, Volume 32, Issue 10, 1457–1465, doi: 10.1093/heapol/czx123
Implementation research (IR) focuses on understanding how and why interventions produce their effects in a given context. This often requires engaging a broad array of stakeholders at multiple levels of the health system. Whereas a variety of tools and approaches exist to facilitate stakeholder engagement at the national or institutional level, there is a substantial gap in the IR literature about how best to do this at the local or community level. Similarly, although there is extensive guidance on community engagement within the context of clinical trials—for HIV/AIDS in particular—the same cannot be said for IR. We identified a total of 59 resources by using a combination of online searches of the peer-reviewed and grey literature, as well as crowd-sourcing through the Health Systems Global platform. The authors then completed two rounds of rating the resources to identify the ‘10 best’.
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Jessani N, Kennedy C and Bennett S (2016) The Human Capital of Knowledge Brokers: An analysis of attributes, capacities and skills of academic teaching and research faculty at Kenyan schools of public health, Health Research Policy and Systems, 14:58, doi:10.1186/s12961-016-0133-0
Academic faculty involved in public health teaching and research serve as the link and catalyst for knowledge synthesis and exchange, enabling the flow of information resources, and nurturing relations between ‘two distinct communities’ – researchers and policymakers – who would not otherwise have the opportunity to interact. Their role and their characteristics are of particular interest, therefore, in the health research, policy and practice arena, particularly in low- and middle-income countries. We investigated the individual attributes, capacities and skills of academic faculty identified as knowledge brokers (KBs) in schools of public health (SPH) in Kenya with a view to informing organisational policies around the recruitment, retention and development of faculty KBs.
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In this short video, FHS CEO, Sara Bennett highlights some of the headlines from FHS activities during its second phase.
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This brief reflects upon the experience of FHS, a DFID funded RPC, with research capacity development. While FHS espoused a strong commitment to capacity development and put together a package of related strategies to support research capacity development among its partner organizations, these strategies met with varying degrees of success. We consider which types of capacity development strategies may work best for RPCs and under what circumstances.
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Bennett S and Peters D, (2015) Assessing National Health Systems: Why and How, Health Systems & Reform 1(1):9-17, DOI:10.1080/23288604.2014.997107
In reviewing national health systems assessments (HSAs), the authors identify four primary rationales for doing HSAs: (i) to motivate health systems reform, (ii) to promote harmonization and alignment across actors in the health system, (iii) to help translate health systems reforms into meaningful ways to track performance, and (iv) to facilitate learning through cross-country comparisons. The authors propose a set of principles to guide HSAs.
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Droppert H, Bennett S (2015) Corporate social responsibility in global health: an exploratory study of multinational pharmaceutical firms, Globalization and Health 2015 11:15, DOI: 10.1186/s12992-015-0100-5
As pharmaceutical firms experience increasing civil society pressure to act responsibly in a changing globalized world, many are expanding and/or reforming their corporate social responsibility (CSR) strategies. The authors of this journal article sought to understand how multinational pharmaceutical companies currently engage in CSR activities in the developing world aimed at global health impact, their motivations for doing so and how their CSR strategies are evolving.
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The potential for academic research institutions to facilitate knowledge exchange and influence evidence-informed decision-making has been gaining ground. Schools of public health (SPHs) may play a key knowledge brokering role—serving as agencies of and for development. Understanding academic-policymaker networks can facilitate the enhancement of links between policymakers and academic faculty at SPHs, as well as assist in identifying academic knowledge brokers (KBs). Using a census approach, the authors administered a sociometric survey to academic faculty across six SPHs in Kenya to construct academic-policymaker networks.
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Given the rapid evolution of health markets, learning is key to promoting the identification and uptake of health market policies and practices that better serve the needs of the poor. However there are significant challenges to learning about health markets. We discuss the different forms that learning takes, from the development of codified scientific knowledge, through to experience-based learning, all in relationship to health markets.
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The bottom of the pyramid concept suggests that profit can be made in providing goods and services to poor people, when high volume is combined with low margins. To-date there has been very limited empirical evidence from the health sector concerning the scope and potential for such bottom of the pyramid models. This paper analyzes private for-profit (PFP) providers currently offering services to the poor on a large scale, and assesses the future prospects of bottom of the pyramid models in health.
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Despite significant investments in health systems research (HSR) capacity development, there is a dearth of information regarding how to assess HSR capacity. An alliance of schools of public health (SPHs) in East and Central Africa developed a tool for the self-assessment of HSR capacity with the aim of producing institutional capacity development plans.
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The goal of Future Health Systems (FHS) is to improve access, affordability and quality of health services for the poor. In order to build resilient health systems for the future, we generate high quality scientific knowledge about how health systems can better deliver basic health services to the world’s poor. FHS supports its country research teams to identify and respond to health system challenges identified by local stakeholders. This annual report from the period 2012-13 captures our ongoing research, research uptake, and capacity building activities.
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Over the past decade, development assistance for health (DAH) in Uganda has increased dramatically, surpassing the government’s own expenditures on health. Yet primary health care and other priorities identified in Uganda’s health sector strategic plan remain underfunded. Using data available from the Creditor Reporting System (CRS), National Health Accounts (NHA), and government financial reports, the article examines trends in how donors channel DAH and the extent to which DAH is aligned with sector priorities.
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Sara Bennett's presentation, with audio, from the Private Sector in Health's webinar - Shaping future health markets: Reflections from Bellagio.
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Although health interventions start with good intentions to develop services for disadvantaged populations, they often distort the health market, making the delivery or financing of services difficult once the intervention is over: a condition called the ‘Develop-Distort Dilemma’ (DDD). In this paper, we describe how to examine whether a proposed intervention may develop or distort the health market. Our goal is to produce a tool that facilitates meaningful and systematic dialogue for practitioners and researchers to ensure that well-intentioned health interventions lead to productive health systems while reducing the undesirable distortions of such efforts.
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In recent years, there have been several calls for rigorous health policy and systems research to inform efforts to strengthen health systems (HS) in low- and middle-income countries (LMICs), including the use of systems thinking concepts in designing and evaluating HS strengthening interventions. The objectives of this paper are to assess recentevaluations of HS strengthening interventions to examine the extent to which they ask a broader set of questions, and provide an appropriately comprehensive assessment of the effects of these interventions across the health system.
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