Innovations for equity

Posts Tagged ‘global symposium’

The scale and scope of private contributions to health systems

In Global Symposium on Health Systems Research, Health Markets on December 7, 2010 at 4:02 pm

BY HEALTHER KINLAW, GUEST BLOGGER FROM THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, GLOBAL HEALTH GROUP

The private sector provides more than half of the health services in Africa and Asia, measured both by source of financing for health services, and place of health service delivery.  While new data and better mapping of providers are improving the understanding of the scale of private healthcare services in low- and middle-income countries (LMICs), issues of dual public-private employment, undercounting of unregistered practitioners, and public sector distrust remain barriers to a full accounting of the size or the activities of the sector. To encourage filling this knowledge gap, in May 2010, the 63rd World Health Assembly passed a resolution called, “Strengthening the capacity of governments to constructively engage the private sector in providing essential health-care services,” which acknowledged that private providers are a major source of care in most countries, that private provision of services can lead to innovation as well as great challenges,  and that governments in LMICs can more effectively engage with and regulate private providers.

On November 17, 2010 researchers held a session entitled “The scale and scope of private contributions to health systems” as part of the First Global Symposium on Health Systems Research (HSR) – Science to Accelerate Universal Health Coverage hosted by the World Health Organization (WHO) and partners in Montreux, Switzerland to provide updates of current research on the private sector, highlight innovative financing mechanisms, and address future topics for research. The session was conducted as a “fishbowl conversation” to encourage audience participation; the design includes speaker chairs arranged in an inner circle that represents the fishbowl with one chair left empty for any member of the audience to occupy, at any time, at which point an existing member of the fishbowl must voluntarily leave to free a chair.  Speakers represented a growing group of researchers that have met regularly for the last five years to share findings and advances in research methods for studying the private sector from the perspective of public health, epidemiology, health economics, public policy, and management.  They included:

  • Sara Bennett,  Johns Hopkins Bloomberg School of Public Health (chair)
  • Ruth Berg, Abt Associates
  • Gerry Bloom, Institute of Development Studies
  • Tania Boler, Marie Stopes International
  • Kara Hanson, London School of Tropical Medicine and Hygiene
  • Birger Forsberg, Karolinska Instituet
  • Gina Lagomarsino, Results for Development Institute
  • Dominic Montagu, Global Health Group, University of California, San Francisco
  • Stefan Nachuk, Rockefeller Foundation
  • Gustavo Humberto Nigenda Lopez, National Institute of Public Health, Mexico

Speakers were asked to share their individual and institutional experience on innovative financing mechanisms which included: the Affordable Medicines Facility – malaria (AMFm), several national health insurance experiences, and public-private partnerships for regulation and otherwise.  Speakers also addressed communities of practice and other tool-sharing platforms that aim to make advances towards adoption of standardized methods for assessing private practitioners, their patients, and private funding flows using both secondary data sources and primary data collection, including: Social Franchising 4 Health (SF4Health.org), the Center for Health Market Innovation (healthmarketinnovations.org), Strengthening Health Outcomes through the Private Sector (shopsproject.org), The Alliance for Health Policy and Systems Research, Future Health Systems, Eldis on health systems, id21, and more by the World Bank and others.

Speakers and audience members suggested the following areas for future research: more anthropological studies around private provider behavior, motivations, and incentives; regulating counterfeit drugs within the private sector; consideration of the human resource aspects of the private sector, including recruitment and training, in their work; payment mechanisms and incentiving patients as well as providers; the increase of “payer” attention to the private sector, including governments; the role of purchasing (financial accounting, standards, etc.); the efficacy of various regulatory partnerships; quality of clinical service delivery; quality of chemical sellers (given that one longitudinal study by KEMRI found no significant difference between quality of chemical shops routinely inspected and those not).

Speakers reported on several upcoming literature reviews underway around the private sector: the Global Health Group at UCSF is conducting a Cochrane Review on health outcomes in publicly-vs-privately provided settings in LMICs and a review with Results for Development and the CHMI on informal providers.  At least one systematic review on voucher programs and health is also in progress.

Throughout the session, speakers also emphasized the economic booms occurring in Asia, and the private health sector growth that has quickly followed and stressed that in many significant amounts of delivery and care are happening outside of the regulatory system, including a prominent informal sector in many countries.  Finally, speakers called for greater transparency around public-private partnerships to ensure efficacy and lesson sharing.

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Blog round up

In Global Symposium on Health Systems Research on November 26, 2010 at 12:36 pm

BY KATE HAWKINS, INSTITUTE OF DEVELOPMENT STUDIES

We have all arrived home from the Global Symposium and I’ve had a little bit of time to browse web coverage to see what news and views filtered out from Montreux into the public realm. Given the conference organisers’ desire to archive learning from the meeting and reach out to a wide audience to prompt interest in this area of research it’s useful to see what areas captured people’s imagination.

Scidevnet have covered the symposium with regular updates from T V Padma their South Asia Regional Coordinator. Issues covered included:

  • The need to increase research capacity in developing countries and encourage collaborative learning and research into policy
  • Researching complex systems
  • Tackling TB and HIV in Ukraine and Russia through a system wide approach
  • The challenge of tackling health financing
  • Gaps in universal health coverage in Sub-Saharan Africa

Meanwhile in their news section Aisling Irwin covers the announcement made in the closing session of the creation of a new international entity under their headline, “Ailing Global Forum for Health Research joins COHRED.”

We are big fans of the BMJ and were happy to see our friend and colleague Tracey Koehlmoos of ICDDR,B was providing them with updates. She commented,

“In addition to the plethora of great plenary speakers and interesting sessions, is the real benefit of coming together with so many of my global colleagues. For many of us, we fight the war on poverty and disease from the frontlines in developing countries. Some groups work in relative isolation or grouped on the occasional multi-country study. We often only hear of one another or read one another’s research findings through publications.   After exercising early, I sat alone at breakfast the other morning, and within twenty minutes I was surrounded by a large group of South Asian colleagues most of whom had not met previously but we had all heard of one another and some of us had corresponded with one another via e-mail.  It was transformational to sit face to face and talk about our common challenges in the region.  I left the table feeling empowered —and pretty sure that we will figure out a way to work together in near future.”

If you see any other good news reporting on the symposium please do let us know…

See Sara on film talking in the plenary at the Global Symposium

In Global Symposium on Health Systems Research, Uncategorized on November 25, 2010 at 4:22 pm

It is now possible to see Sara Bennett’s plenary presentation on the web. You can also download her PowerPoint presentation from the Global Symposium site.

Learning by doing and applying our learning: What are the strategies and institutional options?

In Global Symposium on Health Systems Research, Uncategorized on November 23, 2010 at 2:39 pm

BY KATE HAWKINS, INSTITUTE OF DEVELOPMENT STUIDES
BASED ON NOTES BY LIGIA PAINA, JOHNS HOPKINS SCHOOL OF PUBLIC HEALTH

Learning by doing sounds a nebulous concept but actually it is crucial in health systems development. If we can’t understand the process of intervening in the system and the positive and negative outcomes of our actions how can we improve the work that we are doing? The last decade has seen a rapid increase in the number of institutions such as learning platforms, health observatories, and think tanks. But at the same time, there is a lack of clarity in the difference between them, as well as their pros and cons.

This Future Health Systems Consortium session at the Global Symposium included presentations from the Asian Observatory on Health Systems, The Zambian Forum for Health Research, Health Intervention and Technical Assessment Program (HITAP) Thailand and The China National Health Development Research Center. It tried to better understand the work that they are doing as well as the challenges that they face. Read the rest of this entry »

Blogs we like: The Center for Health Market Innovations

In Global Symposium on Health Systems Research on November 23, 2010 at 8:12 am

KATE HAWKINS, INSTITUTE OF DEVELOPMENT STUDIES

Sitting in the Global Symposium marketplace is a good way of finding more about other projects and the people that make them tick. We were lucky to have the Center for Health Market Innovations as our neighbour. Rose, their Program Officer, has been kind enough to link to our blog. You should check them out, this is what they say about their blog:

The Center for Health Market Innovations (CHMI) blog features news about promising new programs, innovative collaborations, relevant resource articles, and editorial pieces authored by members of the CHMI community. These editorial pieces are intended to further conversations about health market trends, national health policies, and improving health care for the poor. We encourage you to participate in this dialogue in the comments section or suggesting a post to rreis at resultsfordevelopment.org.

Networking at the Global Symposium

In Global Symposium on Health Systems Research, Uncategorized on November 21, 2010 at 3:55 pm

Whilst we were very busy at the conference the Future Health Systems Consortium also found some time to catch up with old friends and to meet new ones.

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From Montreux – the First Global Symposium on Health Systems Research

In Global Symposium on Health Systems Research, Uncategorized on November 21, 2010 at 2:21 pm

BY MICHAEL LOEVINSOHN, GUEST BLOGGER FROM THE STEPS CENTRE

You know you’re a discipline or a significant sub-discipline when you can organize and find funding for a global symposium. Twelve hundred participants from umpteen countries also testify to the self-awareness that marks a field. And the Symposium’s theme is fittingly ambitious: Science to Accelerate Universal Health Coverage.

Charlie Chaplin is in town but can’t make it to the Symposium. He’s buried just down the road. But I wonder what his Little Tramp, bowler-hatted and down-at-heels, would make of it. Would he be considered part of the System? Am I? My interest is in the determinants of disease in the turbulent social, economic and natural environment and what that understanding can contribute especially to prevention. Read the rest of this entry »

Catalysing political will to build health systems research capacity

In Global Symposium on Health Systems Research on November 19, 2010 at 10:55 am

BY KATE HAWKINS, INSTITUTE OF DEVELOPMENT STUDIES

Sara in plenarySara Bennett, from Johns Hopkins School of Public Health, gave a rousing plenary speech on the final day of the Global Symposium. She argued that all stakeholders – policy makers, service providers, the leaders of research organisations, funders and health development partners – need to come together to support capacity development for health systems research. Health systems research capacity development can be seen as worthy but dull and it may not be compelling to donors. Yet there are a lot of exciting innovations in research capacity development occurring in low and middle income countries. Read the rest of this entry »

Sexy, maybe. Fun, definitely!

In Global Symposium on Health Systems Research, Uncategorized on November 18, 2010 at 8:49 am

BY ELIZABETH EKIRAPA-KIRACHO, MAKERERE UNIVERSITY PUBLIC HEALTH

In response to Nandini’s question can research make health systems sexier?  I guess it can it all depends on the researchers line of thought. I have been part of the Future Health Systems Consortium for five years and believe me I have realised that health systems research can be lots of fun! You must be wondering why. This particular consortium allows you to be creative and innovative. Nobody tells you what to research on, you decide what is relevant for you and you think of innovative ways to solve the problems that plague health systems in developing countries. This is a big lesson for developing countries we need to start thinking and doing what we think is best for us in our context. During this Global symposium, the issue of context is coming out strongly context matters in health systems research. We know our context best we should get into the driver’s seat.

Two quotations will stay with me after all is said and done at this conference. The one by Davis Miles “don’t play what’s there play what’s not there.” I look forward to researching on health systems topics that are still a puzzle. As part of the safe deliveries study, we are piloting a study that gives mothers access to delivery and postnatal care services in Eastern Uganda using vouchers.  Institutional deliveries have increased tremendously! Great but the question remains how can you scale up this initiative in a resource constrained country?

The second quotation is by Abbas Bhuia “Leave a mark in the field where you are researching.” I guess not only a mark of excellent research but a mark that you have made a difference in the lives of the people in that community.

Would you like an injection with that Happy Meal?

In Global Symposium on Health Systems Research, Uncategorized on November 17, 2010 at 9:23 pm

BY DANIELA LEWY, JOHNS HOPKINS SCHOOL OF PUBLIC HEALTH

I started my career in education, transitioned to corporate training, and then navigated into public health. But with each professional shift – not much seems particularly different. Universal Education and Universal Healthcare; supply/demand principles at Johns Hopkins Hospital and supply/demand principles at Mars Corporation; and increased salaries for teachers, nurses, or accountants doesn’t always translate to better test scores, fewer infections, or less bankruptcy. 

So when yesterday’s session on social franchising began with a reference to McDonalds – I sat up straight. I like the intersection of seemingly disparate fields.  Read the rest of this entry »