Private Sector Participation in Health Care in Zimbabwe: What’s the Value Added and Institutional Challenges?

This paper analyses the private healthcare sector’s role in Zimbabwe’s health delivery system, especially after economic challenges reduced in real terms fiscal support for public health system funding. This paints a sharp contrast between practicalities of achieving affordable and accessible public healthcare on one hand, and the economic and social realities of underfunded and skills-constrained health systems. Using as empirical models and analytical lenses the country’s 2009–2013 National Health Strategy and the WHO’s health system building blocks, we examine the role played by private sector health delivery actors in the last 10 years and suggest that although the private sector added value, there is a bigger challenge of weak macro-level coordination and communication within the health sector which create problems for systemic design, strategy formulation and feedback mechanisms, important for institutional innovation and timely responses to changing dynamics. Macro-level coordination can be aided by documentation and standardization of procedures, processes and approaches by different health delivery actors to align with national health delivery goals, allowing more predictable and measurable impact from interventions by different actors

The influence of stakeholder relations on the implementation of information systems strategy in public hospitals in South Africa: an activity theory perspective

Includes bibliographical references.Literature reveals that there exists a research gap between the development of information systems (IS) strategy and the implementation thereof. There is also a need for further research regarding the implementation of IS strategy in public hospitals in South Africa. The exploration of implementation in the context of public hospitals in South Africa, a country with many good policies and strategies that have been developed but that are not always implemented, is highly relevant. In this study we undertook to explore the intricacies of stakeholder relations and the implications of these relations on the implementation of IS strategy in public hospitals in South Africa. This research was interpretive following a case study approach. Two provinces of South Africa were selected as cases: the Western Cape province and the Kwazulu Natal province. The Activity Analysis and Development (ActAD) framework, an enhanced form of activity theory, was used as the theoretical framework. Data was collected using semi-structured interviews, meetings, documents analysis and physical artefacts observation. The collected data was analysed using thematic analysis. The findings of this study reveal that factors related to stakeholder relations include the situational stakeholder relations dynamics and the level and motive of involvement in IS strategic activities and IS strategy operationalization processes at the different hierarchical levels. These factors affect the implementation of the IS strategy in public hospitals in South Africa by influencing different elements of the IS strategy implementation activity system. In the end we developed a framework, the stakeholder relations’ influence (SRI) framework which depicts the influence of stakeholder relations on the implementation of IS strategy in public hospitals in South Africa

Globalization, Health Sector Reform, Gender and Reproductive Health

Explores the interrelationships between globalization and health sector reforms, and how changes in macro-economic and social policies affect women's reproductive health and rights

Business models for sustained ehealth implementation: lessons from two continents

There is general consensus that Computers and Information Technology have the potential to enhance health systems applications, and many good examples of such applications exist all over the world. Unfortunately, with respect to eHealth and telemedicine, there is much disillusionment and scepticism. This paper describes two models that were developed separately, but had the same purpose, namely to facilitate a holistic approach to the development and implementation of eHealth solutions. The roadmap of the Centre for eHealth Research (CeHRes roadmap) was developed in the Netherlands, and the Telemedicine Maturity Model (TMMM) was developed in South Africa. The purpose of this paper is to analyse the commonalities and differences of these approaches, and to explore how they can be used to complement each other. The first part of this paper comprises of a comparison of these models in terms of origin, research domain and design principles. Case comparisons are then presented to illustrate how these models complement one another

Achieving accountability through decentralization : lessons for integrated river basin management

While decentralization holds out the promise of increased flexibility and efficiency, the preconditions for realizing it are daunting. To draw lessons for productive decentralization in integrated river basin management, this paper surveys the decentralization experience in education, health care, roads, irrigation, and public infrastructure services. Case studies reveal that the prime focus in the design of a decentralized structure must be accountability, based on principles of subsidiarity, transparency, and allocation of property rights. While some debates are sector-specific, others, such as the need for political and financial accountability, the related data requirements, educating stakeholders and potential beneficiaries of the new system, and ensuring effective participation are true of decentralization wherever it is to unfold. Inturn, initial conditions and the adaptation of political leadership to suit the historical context determine the success of decentralization. Four issues demand high priority in integrated river basin management. These are (1) overcoming financial inadequacy at the local level; (2) commitment to upgrading skills, particularly management skills, while also ensuring that the expertise accumulated in central bureaucracies is not dissipated; (3) assuring pre-reform beneficiaries that their rights would be protected; and (4) sustaining a long-term commitment to an inevitably slow and drawn out decentralization process. The main conclusions of the literature survey caution those who believe that decentralization is, in itself, a solution to problems of inefficiency and inequity in developing countries. Tradeoffs and tensions need to be reconciled (such as economies of scale versus local monitoring and integrated management or interregional equity versus local control).Municipal Financial Management,Decentralization,Water Conservation,Banks&Banking Reform,Environmental Economics&Policies,Municipal Financial Management,Environmental Economics&Policies,National Governance,Water Supply and Sanitation Governance and Institutions,Banks&Banking Reform

Private Enterprise for Public Health: Opportunities for Business to Improve Women's and Children's Health

This guide, developed by FSG and published by the Innovation Working Group in support of the global Every Woman, Every Child effort, explores how companies can create shared value in women's and children's health. The document sets out opportunities for multiple different industries to develop new product and services, improve delivery systems and strengthen health systems that can support global efforts to save 16 million women's and children's lives between now and 2015. It particularly notes that companies need not wait for health services to "catch up" with their economic model, but rather they can work proactively to help accelerate change, by partnering with other industries, civil society and the public sector to create collective impact in a specific location. The aim of the guide is to catalyze these transformative partnerships

Competing by Saving Lives: How Pharmaceutical and Medical Device Companies Create Shared Value in Global Health

This report looks at how pharmaceutical and medical device companies can create shared value in global health by addressing unmet health needs in low- and middle-income countries. Companies have already begun to reap business value and are securing competitive advantages in the markets of tomorrow

Sustainability Capacity of HIV/AIDS Programmes in YOGYAKARTA, Indonesia

The Indonesian government established the prevalence target of HIV <0.50% in 2019 to control the spreading of HIV through the National Medium Term Development Plan. To ensure the sustainability of this development plan, a study of the strategic capacity of HIV/AIDS programmes is needed to provide an overview so that the program can be sustained over time. This study aimed to explore the sustainability capacity of HIV/AIDS programmes in Yogyakarta. This was a descriptive study utilizing a qualitative approach. The study involved 42 participants as key informants selected by a purposive sampling technique, and the data were examined using content analysis. By setting priorities of the local government supported by the Provincial Health Office and with the coordination of the Yogyakarta Province AIDS Commission, the programs are able to maintain sustainable HIV and AIDS programmes in Yogyakarta. Funding capacity, evaluation, programme adaptation and communication have not been optimal to ensure the sustainability. Stability of funding is the main obstacle to achieving the sustainability of HIV and AIDS programs. However, with good planning, partnership structure and sufficient organizational capacity, this approach can ensure the HIV and AIDS programmes will continue with the targets set by the Yogyakarta Provincial Health Office. The government in Yogyakarta needs to increase funding capacity, and improve communication to ensure sustainability. The strategy should include adaptation and evaluation of programs through strengthening private sector financing, formulating a communication plan and improving the capacity to respond to change