Bottlenecks and benevolence: how the World Bank is helping communities to ‘cope’ with HIV/AIDS

© 2015, SAGE

Epidemiology of the health impact of pesticide use in Zimbabwe

A study of the implications of pesticide exposure to Zimbabwe's occupational health regulations.About 30-50 per cent of the workers on large-scale commercial farms involved in pesticide use in Zimbabwe are exposed to organophosphates during the spraying season. Pesticide exposure is associated with use of manual techniques, little provision of protective clothing and inadequate safety information. There is evidence that pesticide exposure spills over into non-spravers and into the communities living on farms. Hospital admissions for acute poisoning appeal' to be a poor guide to the extent of sub-acute or chronic exposure to pesticides, given the extent of exposure documented in the surveys. The use of simple biological monitoring techniques can be extremely useful in epidemiological assessment of patterns and possible sources of exposure. The findings of the studies reported in this chapter add weight to the growing body of evidence that there is a need for a greater allocation of resources towards identifying and controlling the negative health impact of pesticide use in developing countries

Public Participation in Health Systems in Zimbabwe

Summary This article outlines some of the challenges faced in moving away from a health system largely planned and governed by technical personnel to one that involves wider public participation and accountability in planning, implementing and monitoring health services. It considers factors that contribute to motivation for changes in approach, and towards a greater degree of community participation in mechanisms for and the governance of health service delivery. Set within the current environment of real declines in access to health care in Zimbabwe, the liberalisation of health providers and consequent demand for informed consumers, the article explores consumer demand for improved quality services and ways to tackle the need to ensure greater impact in resource use. It explores changing roles within health policy reforms and in relation to processes of decentralisation. It considers health service motivations to widen resource mobilisation strategies, and particularly community contributions to health. The article outlines the perceptions of civic groups, elected and traditional leaders and health service providers in how participation should be restructured in Zimbabwe, noting the general call for greater participation in the planning of resource mobilisation and allocation approaches and of monitoring quality of care. It discusses mechanisms for making such a shift, and the issues to be faced in doing so

Participatory action research in health systems : a methods reader

This “reader” in participatory action research (PAR) serves to inform, motivate and strengthen PAR as a research methodology useful for both health policy and systems research. It includes examples of PAR across all income areas and global regions, and provides a selection of readings on the subject. The texts are backed by references and resources, as well as ethics concerns and innovations in the field. Methods and tools for gathering evidence along with context are demonstrated, as well as guidance in the communication of findings. Social determinants of health may be more easily factored in to qualitative and participatory action research endeavours

Equitable recovery from COVID-19 : Bring global commitments to community level

Acknowledgements This paper results from a cooperation between the authors in a project coordinated by Training and Research Support Centre in association with University of Aberdeen on Building policy support for Family and Child Health and Well-being (https://www.shapinghealth.org/case-studies-fchw). We acknowledge the Robert Wood Johnson Foundation and the Charities Aid Foundation of America for support of the project. Funding We acknowledge a prior Robert Wood Johnson Foundation and the Charities Aid Foundation of America (RWJF/CAFA) grant for background work on building policy support for family and child health and wellbeing.Peer reviewedPublisher PD

Pay for performance at a crossroads:Lessons from taking a global perspective

Purpose: The use of pay for performance (P4P) as an instrument to incentivise quality improvements in health care is at a crossroads in high-income countries but has remained a commonly used tool in low- and middle-income countries. The authors aimed to take stock of the evidence on effectiveness and design from across income settings to reveal insights for the future design of performance payment across income contexts. Design/methodology/approach: The authors identified Cochrane literature reviews of the use of P4P in health care in any income setting, tracked the development in the quantity and quality of evidence over time, and compared the incentive design features used across high-income countries compared to low- and middle-income countries. Findings: The quantity and quality of the evidence base have grown over time but can still be improved. Scheme design varies across income settings, and although some design choices may reflect differences in context, the authors find that incentive designers in both income settings can learn from practices used in the other setting. Originality/value: The research and literature on P4P in high-, low- and middle-income countries largely operate in silos. By taking stock of the evidence on P4P from across income settings, the authors are able to draw out key insights between these settings, which remain underexplored in the literature

Pay for performance at a crossroads: lessons from taking a global perspective

Purpose: The use of pay for performance (P4P) as an instrument to incentivise quality improvements in health care is at a crossroads in high-income countries but has remained a commonly used tool in low- and middle-income countries. The authors aimed to take stock of the evidence on effectiveness and design from across income settings to reveal insights for the future design of performance payment across income contexts. Design/methodology/approach: The authors identified Cochrane literature reviews of the use of P4P in health care in any income setting, tracked the development in the quantity and quality of evidence over time, and compared the incentive design features used across high-income countries compared to low- and middle-income countries. Findings: The quantity and quality of the evidence base have grown over time but can still be improved. Scheme design varies across income settings, and although some design choices may reflect differences in context, the authors find that incentive designers in both income settings can learn from practices used in the other setting. Originality/value: The research and literature on P4P in high-, low- and middle-income countries largely operate in silos. By taking stock of the evidence on P4P from across income settings, the authors are able to draw out key insights between these settings, which remain underexplored in the literature

Fair publication of qualitative research in health systems: a call by health policy and systems researchers.

[Extract] An open letter from Trisha Greenhalgh et al. [1] to the editors of the British Medical Journal (BMJ) triggered wide debate by health policy and systems researchers (HPSRs) globally on the inadequate recognition of the value of qualitative research and the resulting deficit in publishing papers reporting on qualitative research [2]. One key dimension of equity in health is that researchers are able to disseminate their findings and that they are taken into account in a fair and just manner, so that they can inform health policy and programmes. The Greenhalgh et al. letter and editorial responses [3, 4] were actively discussed within "SHAPES", a thematic group within Health Systems Global, focused on Social Science approaches for research and engagement in health policy & systems (http://healthsystemsglobal.org/twg-group/6/Social-science-approaches-for-research-and-engagement-in-health-policy-amp-systems/) and within EQUINET, a regional network working on health equity research in East and Southern Africa (www.equinetafrica.org). Our discussion precipitated in this follow up open letter/commentary, which has 170 co-signatories. Collectively, we feel that barriers to publication of qualitative research limit publication of many exemplary studies, and their contribution to understanding important dimensions of health care, services, policies and systems