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JohnCampbell
Each month we share the latest articles, stories, and research we are reading that relate to innovative health practices.
Globalization & Health – New forms of development: branding innovative ideas and bidding for foreign aid in the maternal and child health service in Nepal
Radha Adhikhari et al
"Nepal, like many other LMICs, will only begin to make advances toward achieving UHC when foreign aid is used to strengthen the national health system in long-term, sustainable ways."
The authors point out in this paper that the challenge with projectized investments in innovative maternal and child health interventions is not that they do not work, but that they tend to create islands of impact amidst a sea of solutions which fail to address the systemic challenges of Nepal’s health system and the multiplicity of factors that influence the outcomes of individuals who depend on its services. This study underscores the importance of sustainable, high-quality care to reduce maternal and child mortality in the long term.
HSG blog – A quality of care revolution gains traction in Africa
Sarah Mintz
Sarah Mintz, member of the Health Systems Global Thematic Working Group on Quality in Universal Health and Health Care, reflects on the first Africa Forum on Quality and Safety in Healthcare in Durban, which she attended in February.
“As the quality revolution gains momentum, systematic measurement deserves to be at the center of the evolving agenda to produce reliable and comparable data. Without such measurement efforts to underpin and guide quality improvement, raising, and then scaling, quality will be difficult.”
It is clear that patients’ expectations for high-quality care is increasing at an accelerated pace across the globe. There are, however, still significant hurdles to clear. For instance, data on healthcare use greatly improved in the era of the MDGs, yet evidence on the quality and effectiveness of care in LMICs is remains scant. This has to change because, as this blog suggests, the "quality revolution" currently underway in Africa is a bellwether of change. Measurable improvement in the quality of health outcomes is no longer a “rich country” aspiration for a distant future — it is absolutely essential for achieving global health goals and the most fundamental obligation every health system has to its users.
Globalization & Health – Health system innovations: adapting to rapid change
Gerald Bloom et al
“This paper introduces the Thematic Issue on Innovation in Health Systems in Low- and Middle-Income Countries. The purpose of this thematic issue is to stimulate analyses of innovation in the context of complex and dynamic health systems. Although the focus is on low and middle-income countries, the papers have a wider geographic relevance.”
This important and timely editorial written by Gerald Bloom is a poignant reminder that although innovations in health products, practices, and technologies have the potential to revolutionize global health, they can do so only when integrated into dynamic and responsive health systems.
CGD – Perspective in Economic Evaluations of Healthcare Interventions in Low- and Middle-Income Countries: One Size Does Not Fit All
Kalypso Chalkidou
“As developing nations are increasingly adopting economic evaluation as a means of informing their own investment decisions, new questions emerge. Is adopting a broader perspective to include, say, the non-health-related benefits of healthcare interventions, a wise strategy? Is it what LMICs governments want? Would it attract more internal and external funding to health? Is breaking down the funding silos—disease by disease, sector by sector—possible or even desirable? Does the choice of perspective in economic analyses matter for countries in pursuit of Universal Health Coverage (UHC)? Our answer is that it all depends. The right answer to the question “which perspective?” is the one tailored to these local specifics. We conclude that there is no one-size-fits-all and that the one who pays must set or have a major say in setting the perspective.”
An important message emerging from this paper is that economic evaluations of healthcare interventions are often based on unrealistic assumptions about the overall functioning of health systems in LMICs. We must never forget that the expected costs and effects of implementing a healthcare innovation, for example, depend on accompanying investments in health systems to support their scale and impact. Funders, policy makers, and innovators therefore need to shift their collective mindset to temper the strict reliance on economic evaluations with an understanding that context matters.
BMJ editorial – Funding innovation in neglected diseases
Gavin Yamey et al
“Concerted action is required to reverse downward trends in research and development.” “How can this trend be reversed? Strategies to mobilize funding should engage governments from high, low, and middle-income countries, philanthropic foundations, and the private sector. We propose five interconnected approaches.”
Now, more than ever before, concerted action is needed to reverse the decline in research and development to address neglected diseases. Gavin Yamey’s recent paper makes a convincing case in support of the need for renewed global commitment and new models of collaboration among stakeholders to bring about innovative solutions to control these neglected diseases. The paper also stresses the importance of translating these transformative solutions into effective programs in settings where the needs are greatest.
