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Understanding the dynamic interactions driving Zambian health centre performance: a case-based health systems analysis.

Topp SM, Chipukuma JM, Hanefeld J - Health Policy Plan (2014)

Bottom Line: Despite being central to achieving improved population health outcomes, primary health centres in low- and middle-income settings continue to underperform.Weak health information systems and lack of performance data undermined providers' answerability to their employer and clients, and a lack of effective sanctions undermined supervisors' ability to hold providers accountable for these transgressions.Health centre performance is influenced by mechanisms of accountability, which are in turn shaped by dynamic interactions between system hardware and system software.

View Article: PubMed Central - PubMed

Affiliation: Health Systems Adviser & Research Associate, Centre for Infectious Disease Research in Zambia (CIDRZ), Schools of Medicine, University of Alabama at Birmingham (UAB), Nossal Institute for Global Health, University of Melbourne, Student, University of Lusaka, Zambia Lecturer in Health Systems Economics, Department of Global Health and Development, Faculty of Public Health and Policy London School of Hygiene and Tropical Medicine globalstopp@gmail.com.

No MeSH data available.


Related in: MedlinePlus

Ministry of Health Administrative Structure c. 2011. Adapted from Thet (2007). Arrows indicate channel of authority, financing or influence. DTSS = Directorate of Technical Support Services; DHRA = Directorate of Human Resources and Administration; DPP = Directorate of Policy and Planning; DPHR = Directorate of Public Health and Research; DCCD = Directorate of Clinical Care and Diagnostic Services.
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czu029-F1: Ministry of Health Administrative Structure c. 2011. Adapted from Thet (2007). Arrows indicate channel of authority, financing or influence. DTSS = Directorate of Technical Support Services; DHRA = Directorate of Human Resources and Administration; DPP = Directorate of Policy and Planning; DPHR = Directorate of Public Health and Research; DCCD = Directorate of Clinical Care and Diagnostic Services.

Mentions: At the time of study Zambia’s health system was relatively centralized with the Ministry of Health (MOH) responsible for all national health policies as well for direct oversight of tertiary hospital operations. Responsibility for the network of 1500 first and second level health facilities (primary health centres and first and second level hospitals) lay with Provincial and District Health Offices (Figure 1).Figure 1


Understanding the dynamic interactions driving Zambian health centre performance: a case-based health systems analysis.

Topp SM, Chipukuma JM, Hanefeld J - Health Policy Plan (2014)

Ministry of Health Administrative Structure c. 2011. Adapted from Thet (2007). Arrows indicate channel of authority, financing or influence. DTSS = Directorate of Technical Support Services; DHRA = Directorate of Human Resources and Administration; DPP = Directorate of Policy and Planning; DPHR = Directorate of Public Health and Research; DCCD = Directorate of Clinical Care and Diagnostic Services.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4385821&req=5

czu029-F1: Ministry of Health Administrative Structure c. 2011. Adapted from Thet (2007). Arrows indicate channel of authority, financing or influence. DTSS = Directorate of Technical Support Services; DHRA = Directorate of Human Resources and Administration; DPP = Directorate of Policy and Planning; DPHR = Directorate of Public Health and Research; DCCD = Directorate of Clinical Care and Diagnostic Services.
Mentions: At the time of study Zambia’s health system was relatively centralized with the Ministry of Health (MOH) responsible for all national health policies as well for direct oversight of tertiary hospital operations. Responsibility for the network of 1500 first and second level health facilities (primary health centres and first and second level hospitals) lay with Provincial and District Health Offices (Figure 1).Figure 1

Bottom Line: Despite being central to achieving improved population health outcomes, primary health centres in low- and middle-income settings continue to underperform.Weak health information systems and lack of performance data undermined providers' answerability to their employer and clients, and a lack of effective sanctions undermined supervisors' ability to hold providers accountable for these transgressions.Health centre performance is influenced by mechanisms of accountability, which are in turn shaped by dynamic interactions between system hardware and system software.

View Article: PubMed Central - PubMed

Affiliation: Health Systems Adviser & Research Associate, Centre for Infectious Disease Research in Zambia (CIDRZ), Schools of Medicine, University of Alabama at Birmingham (UAB), Nossal Institute for Global Health, University of Melbourne, Student, University of Lusaka, Zambia Lecturer in Health Systems Economics, Department of Global Health and Development, Faculty of Public Health and Policy London School of Hygiene and Tropical Medicine globalstopp@gmail.com.

No MeSH data available.


Related in: MedlinePlus