Accelerating Empowerment for Sustainable Development: The Need for Health Systems Strengthening in Sub-Saharan Africa

Gold, Oyibo Patrick; John, Ejughemre Ufuoma

doi:10.12691/ajphr-1-7-2

Cited by 9 publications

(4 citation statements)

References 27 publications

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“…Much has been written about the generally weak public-sector health systems in many sub-Saharan African countries: poor infrastructure, lack of basic equipment and supplies, low wages, insufficient training and supervision of personnel, weak information systems, frequent stock-outs of medications, and rude or culturally insensitive treatment of clients by providers, among others. 20 , 21 To this list, we add specific challenges that relate to the political situation, as well as supply and demand for contraception in the DRC.…”

Section: Formidable Challengesmentioning

confidence: 99%

Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges

Kwete¹,

Binanga

Mukaba

et al. 2018

Glob Health Sci Pract

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Formidable challenges: uncertain political situation, cultural norms favoring high fertility, a thin patchwork of service delivery institutions, logistical issues in a vast country with weak infrastructure, and low capacity of the population to pay for contraceptive services. Encouraging progress: increasing government and donor support, openness to progressive service delivery policies, innovative programming including robust social marketing and initiatives with nursing schools and the military, strong collaboration among stakeholders, high unmet need suggesting strong latent demand for family planning, and an increasingly balanced method mix including long-acting methods.

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Section: Formidable Challengesmentioning

confidence: 99%

Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges

Kwete¹,

Binanga

Mukaba

et al. 2018

Glob Health Sci Pract

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“…In sub-Saharan Africa (SSA), the prevalence of non-communicable diseases (NCDs) is increasing rapidly [ 1 ], placing a growing burden on already weak health systems in the region [ 2 , 3 ]. At the same time, the use of mobile phones is continuously rising, expanding the opportunities for the implementation of mobile phone-based health interventions (mHealth interventions) [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa

Opoku

Stephani

Quentin

2017

BMC Med

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BackgroundThe prevalence of non-communicable diseases (NCDs) is increasing in sub-Saharan Africa. At the same time, the use of mobile phones is rising, expanding the opportunities for the implementation of mobile phone-based health (mHealth) interventions. This review aims to understand how, why, for whom, and in what circumstances mHealth interventions against NCDs improve treatment and care in sub-Saharan Africa.MethodsFour main databases (PubMed, Cochrane Library, Web of Science, and Google Scholar) and references of included articles were searched for studies reporting effects of mHealth interventions on patients with NCDs in sub-Saharan Africa. All studies published up until May 2015 were included in the review. Following a realist review approach, middle-range theories were identified and integrated into a Framework for Understanding the Contribution of mHealth Interventions to Improved Access to Care for patients with NCDs in sub-Saharan Africa. The main indicators of the framework consist of predisposing characteristics, needs, enabling resources, perceived usefulness, and perceived ease of use. Studies were analyzed in depth to populate the framework.ResultsThe search identified 6137 titles for screening, of which 20 were retained for the realist synthesis. The contribution of mHealth interventions to improved treatment and care is that they facilitate (remote) access to previously unavailable (specialized) services. Three contextual factors (predisposing characteristics, needs, and enabling resources) influence if patients and providers believe that mHealth interventions are useful and easy to use. Only if they believe mHealth to be useful and easy to use, will mHealth ultimately contribute to improved access to care. The analysis of included studies showed that the most important predisposing characteristics are a positive attitude and a common language of communication. The most relevant needs are a high burden of disease and a lack of capacity of first-contact providers. Essential enabling resources are the availability of a stable communications network, accessible maintenance services, and regulatory policies.ConclusionsPolicy makers and program managers should consider predisposing characteristics and needs of patients and providers as well as the necessary enabling resources prior to the introduction of an mHealth intervention. Researchers would benefit from placing greater attention on the context in which mHealth interventions are being implemented instead of focusing (too strongly) on the technical aspects of these interventions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-017-0782-z) contains supplementary material, which is available to authorized users.

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“…It is worth noting that several structural factors, such as economic and environmental settings, country governance, persistent disease burden, and the health system, have been identified as affecting the effectiveness of health spending in SSA (Gold & John, 2013;Ibrahim et al, 2019;Ranabhat et al, 2020). These factors have the potential to either serve as transmission channels or interfere with the association between PHS and population health outcomes.…”

Section: Statement Of the Problemmentioning

confidence: 99%

The effectiveness of public health spending in Sub-Saharan Africa.

Kabongo

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Accelerating Empowerment for Sustainable Development: The Need for Health Systems Strengthening in Sub-Saharan Africa

Cited by 9 publications

References 27 publications

Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges

Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges

A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa

The effectiveness of public health spending in Sub-Saharan Africa.

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