Investments for effective functionality of health systems towards Universal Health Coverage in Africa: A scoping review

Abstract

The health challenges in Africa underscore the importance of effectively investing in health systems. Unfortunately, there is no information on systems investments adequate for an effective functional health system. We aimed to address this by conducting a scoping review of existing evidence following the Joanna Briggs Institute Manual for Evidence Synthesis and preregistered with the Open Science Framework (https://osf.io/bvg4z). We included any empirical research describing interventions that contributed to the functionality of health systems in Africa or any low-income or lower-middle-income regions. We searched Web of Science, MEDLINE, Embase, PsycINFO, Cochrane Library, CINAHL, and ERIC from their inception, and hand-searched other relevant sources. We summarized data using a narrative approach involving thematic syntheses and descriptive statistics. We identified 554 unique reports describing 575 interventions, of which 495 reported evidence of effectiveness. Most interventions were undertaken in Africa (80.9%), covered multiple elements of health systems (median: 3), and focused on service delivery (77.4%) and health workforce (65.6%). Effective interventions contributed to improving single (35.6%) or multiple (64.4%) capacities of health systems: access to essential services (75.6%), quality of care (70.5%), demand for essential services (38.6%), or health systems resilience (13.5%). For example, telemedicine models which covered software (technologies) and hardware (health workers) elements were used as a strategy to address issues of access to essential services. We inventoried these effective interventions for improving health systems functionality in Africa. Further analyses could deepen understanding of how such interventions differ in their incorporation of evidence for potential scale across African countries.

Making districts functional for universal health coverage attainment: lessons from Ghana

“…This may contribute in practice to the limited interest of beneficiaries in engaging with oversight and governance institutional arrangements, even where these exist—with many institutional arrangements resorting to coercive approaches to be able to function ( 32 ). On the other hand, the low functionality of access to essential services mirrors the current evidence, where physical, financial and sociocultural gaps are documented as being the rate limiting step in accelerating movement towards desired health results ( 21 , 33 ). Interestingly, the capacity attributes relating to system resilience are viewed higher than access or quality of care.…”

Telemedicine in Africa: Applications, Opportunities, and Challenges

“…The lack of budgetary allocation for training healthcare professionals, developing robust communication networks, and establishing data centers impedes further progress. Additionally, reliance on external funding and grants creates uncertainties, hinders long-term planning, and raises sustainability concerns [65]. High costs associated with equipment and software are a particularly challenging issue in African nations.…”

Informacinių Technologijų Naudojimo Sąsajos Su Slaugos Kokybe

“…Ji grindžiama įrodymais pagrįstomis profesinėmis žiniomis ir yra labai svarbi, siekiant visuotinės kokybiškos asmens sveikatos priežiūros. Vis dažniau pripažįstama, kad kokybiškos asmens sveikatos priežiūros paslaugos pirmiausia turi būti savalaikės, veiksmingos, saugios ir orientuotos į žmogų [10].…”