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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

Conceptual framework for analysis of health micro-systems (adapted from Sheikh et al., 2011).
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czu029-F3: Conceptual framework for analysis of health micro-systems (adapted from Sheikh et al., 2011).

Mentions: An explicit aim of this research was to move beyond a simple list of contributing factors in order produce generalizable assertions about drivers of service quality in health systems. While the case descriptions were helpful in identifying some of the common factors, this analysis falls short of providing an analytical frame for understanding health system performance more generally. With the aim of developing a deeper understanding of how these hardware–software interactions influenced health centre performance we thus adapted Sheikh et al.’s (2011) framework (Figure 3) to incorporate more explicit mechanisms of effect that shape service delivery across the four sites.Figure 3


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)

Conceptual framework for analysis of health micro-systems (adapted from Sheikh et al., 2011).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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

czu029-F3: Conceptual framework for analysis of health micro-systems (adapted from Sheikh et al., 2011).
Mentions: An explicit aim of this research was to move beyond a simple list of contributing factors in order produce generalizable assertions about drivers of service quality in health systems. While the case descriptions were helpful in identifying some of the common factors, this analysis falls short of providing an analytical frame for understanding health system performance more generally. With the aim of developing a deeper understanding of how these hardware–software interactions influenced health centre performance we thus adapted Sheikh et al.’s (2011) framework (Figure 3) to incorporate more explicit mechanisms of effect that shape service delivery across the four sites.Figure 3

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