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Political economy analysis of the performance‐based financing programme in Afghanistan

Global Health Research and Policy 2021年第1期6卷 414-428页

作者： Ahmad Shah Salehi Karl Blanchet anna vassall Josephine Borghi London School of Hygiene and Tropical Medicine Faculty of Public Health and PolicyDepartment of Global Health and DevelopmentLondonUK CERAH University of GenevaGenevaSwitzerland

Background:Performance-based financing(PBF)has attracted considerable attention in recent years in low and middle-income ***’s Ministry of Public Health(MoPH)implemented a PBF programme between 2010 and 2015 to strengthen the utilisation of maternal and child health services in primary health *** study aimed to examine the political economy factors influencing the adoption,design and implementation of the PBF programme in ***:Retrospective qualitative research methods were employed using semi structured interviews as well as a desk review of programme and policy *** informants were selected purposively from the national level(n=9),from the province level(n=6)and the facility level(n=15).Data analysis was inductive as well as deductive and guided by a political economy analysis framework to explore the factors that influenced the adoption and design of the PBF *** content analysis was used to analyse the ***:The global policy context,and implementation experience in other LMIC,shaped PBF and its introduction in *** MoPH saw PBF as a promise of additional resources needed to rebuild the country’s health system after a period of *** MoPH support for PBF was also linked to their past positive experience of performance-based *** dynamics and interactions between PBF programme actors also shaped the policy *** PBF programme established a centralised management structure which strengthened MoPH and donor ability to manage the programme,but overlooked key stakeholders,such as provincial health offices and non-state ***,MoPH had limited input in policy design,resulting in a design which was not well tailored to the national ***:This study shows that PBF programmes need to be designed and adapted according to the local context,involving all relevant actors in the policy *** studies should focus on conducting empirica

关键词： income policy analysis

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Tuberculosis infection prevention and control:why we need a whole systems approach

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Infectious Diseases of Poverty 2020年第3期9卷 97-100页

作者： Karina Kielmann Aaron S.Karat Gimenne Zwama Christopher Colvin Alison Swartz anna S.Voce Tom A.Yates Hayley MacGregor Nicky McCreesh Idriss Kallon anna vassall Indira Govender Janet Seeley Alison D.Grant The Institute for Global Health and Development Queen Margaret UniversityEdinburgh EH216UUUK TB Centre London School of Hygiene&Tropical MedicineLondonUK Division of Social and Behavioural Sciences Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa Discipline Public Health Medicine School of Nursing and Public HealthUniversity of KwaZulu-NatalDurbanSouth Africa Department of Infectious Disease Faculty of MedicineImperial College LondonLondonUK The Institute of Development Studies University of SussexBrightonUK Department of Global Health and Development Faculty of Public Health and PolicyLondon School of Hygiene&Tropical MedicineLondonUK Africa Health Research Institute School of Nursing and Public HealthUniversity of KwaZulu-NatalDurbanSouth Africa School of Public Health Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa

Infection prevention and control(IPC)measures to reduce transmission of drug-resistant and drug-sensitive tuberculosis(TB)in health facilities are well described but poorly *** implementation of TB IPC has been assessed primarily through quantitative and structured approaches that treat administrative,environmental,and personal protective measures as discrete *** present an on-going project entitled Umoya omuhle(“good air”),conducted in two provinces of South Africa,that adopts an interdisciplinary,‘whole systems’approach to problem analysis and intervention development for reducing nosocomial transmission of Mycobacterium tuberculosis(Mtb)through improved *** suggest that TB IPC represents a complex intervention that is delivered within a dynamic context shaped by policy guidelines,health facility space,infrastructure,organisation of care,and management *** drawn from epidemiology,anthropology,and health policy and systems research enable rich contextual analysis of how nosocomial Mtb transmission occurs,as well as opportunities to address the problem holistically.A‘whole systems’approach can identify leverage points within the health facility infrastructure and organisation of care that can inform the design of interventions to reduce the risk of nosocomial Mtb transmission.

关键词： Drug-resistant tuberculosis Infection prevention and control Health system South Africa

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