Managing Health in Africa: The Health Systems Perspective

by Prosper Tumusiime, Jennifer Nyoni

Overview

An authoritative analysis of the challenges of public health management in Africa, with concrete suggestions on how to overcome them. The three authors have a combined experience of more than 83 years in national and international health work. The topics they cover include the status of public health in Africa today; integrated health services delivery; community involvement in health policy planning and formulation, and health services delivery; health workforce planning, recruitment and retention; availability and management of essential medicines and medical supplies; the role of health technologies in health services delivery; health financing and resource mobilization for health; and monitoring and evaluation of public health programmes. The book has close to 400 pages, with more than 50 illustrations. It will be an invaluable resource for decision makers, students in schools of medicine, all bodies and organizations involved in international health work, all health practitioners, community leaders, health activists, and all those interested in advancing public health in Africa. The book comes in colour and B&W, and is available in hardcover, paperback, and ebook form.

Product Details

ISBN-13:	9780998085753
Publisher:	Service Resource Africa
Publication date:	07/31/2018
Series:	N/A
Pages:	346
Product dimensions:	6.00(w) x 9.00(h) x 0.77(d)

About the Author

Dr Tumusiime was born in Uganda in 1958. His areas of expertise are Epidemiology, Health Policy Development, Health Reform, Programme Management and Public Health Planning. He is currently Team Leader and oversees Health Service Delivery for the governments of the 47 Member Countries of the World Health Organization Regional Office for Africa in Brazzaville, Congo. He has been with WHO since 2000 and has held several senior positions in his areas of expertise within that Organization. Before Dr Tumusiime joined WHO, he served the Government of Uganda as Senior Programme Officer, Assistant Commissioner for Health Services, Deputy Director of Rural and Urban Health Services, and Medical Officer. He graduated from Case Western Reserve University in the USA with an M Sc and a PhD in Epidemiology and Biostatistics. He holds the Doctor of Medicine and a postgraduate diploma in Public Health from Makerere University in Uganda and a certificate in Planning and Management of District Health Services from the Royal Tropical Institute in Amsterdam, The Netherlands. Dr Tumusiime has served on scores of taskforces, has consulted for dozens of international bodies active in health development and management, and is a member of many professional societies. He has published 27 papers in his areas of expertise. He is married, has 4 children, and lives and works in Brazzaville, Republic of Congo.

Jennifer Nyoni was born in 1961 in Zambia. Her areas of expertise are Management of Human Resources; Health Systems Assessment, Policy and Planning; and Monitoring and Evaluation. Since April 2001, she has served the Regional Office of the World Health Organization in Brazzaville, Congo, as Technical Officer in charge of Human Resources for Health (HRH) Management now in the Health Service Delivery Systems Development Unit. In this role, she advises a group of 47 governments on health workforce (HWF) management systems planning and policy development and implementation, capacity building, and health system strengthening in general. Before Jennifer joined WHO, she served the Government of Zambia as Director, Human Resources and Administration; Manager, Human Resources Administrative Systems; Human Resources Development Specialist; Chief Human Resources Development Officer, among other functions. Ms Nyoni holds a Master's degree in Public Administration from the University of Pittsburgh in the USA and a BA degree in Public Administration and Industrial Sociology from the University of Zambia. She also holds various certificates in her areas of expertise from internships in Ottawa, Canada; Dublin, Ireland; and London, United Kingdom. She has published some 15 papers on the theory and practice of human resources development.

Table of Contents

Chapter 1. Status of health in Africa 1

Introduction 1

Epidemics in Africa 9

Double burden of disease 14

Social determinants of health 16

Opportunities for improving the current situation 17

Experiences, good practices, lessons learnt and proposed approaches 18

Summary 23

Exercises and assignments 24

References 26

Chapter 2. Developing and implementing comprehensive national health policies and plans 29

Introduction 29

Status of national health policies and strategic plans in Africa 31

Development of national health policies and national health sector strategic plans 37

Important observations in the development process 43

Implementation of national health policies and national health strategic plans 44

Monitoring and evaluating implementation of strategic plans 47

Summary 49

Exercises and assignments 49

References 51

Chapter 3. Towards client-centred and integrated service delivery 53

Introduction 53

Definitions 55

Service delivery models 57

The nature of integrated health services delivery 59

The situation in Africa 66

Review of experiences 69

Summary 80

Exercises and assignments 81

References 83

Chapter 4. Community involvement in health services organization and delivery 85

Introduction 85

Definitions 86

Rationale 89

Evidence-based community approach 93

Some strategies 95

Some tools and resources to consider 100

Summary 101

Exercises and assignments 103

Chapter 5. How to improve the performance of district health systems 107

Introduction 107

What performance of a health system entails 108

A district health system and its functions 111

Situation in Africa 117

Experiences, challenges, and lessons learnt 120

Summary 126

Exercises and assignments 127

References 131

Chapter 6. Prerequisites for improving resources for the health agenda 133

Introduction 133

The problem with resources in sub-Saharan Africa 135

Prerequisite 1: Effective leadership and governance at all levels 138

Prerequisite 2: Coordinated partnerships 145

Prerequisite 3: Access to health care and health services 151

Estimating resource requirements 152

Making the case for a health agenda 152

Summary 155

Exercises and assignments 156

Chapter 7. Production, recruitment and retention of an efficient workforce 159

Introduction 159

Availability of the health workforce in sub-Saharan Africa 161

The reality on the ground in general 162

Health workforce training 166

A ready and performing health workforce 168

Good practices in workforce motivation and retention 171

Health workers who stay and those who won’t 172

Options at the district or local level 173

Summary 175

Exercises and assignments 178

Chapter 8. Increasing the availability of essential medicines and medical supplies 181

Introduction 181

Definitions 182

Situation of essential medicines and supplies in sub-Saharan Africa 184

Experiences, good practices, and lessons learnt 190

Proposed approaches 195

Summary 198

References 200

Chapter 9. The role of health technologies in improving care and service delivery 203

Introduction 203

Blood transfusion safety 205

Diagnostic and laboratory technology 207

Organ transplants 208

Emergency and essential surgical care 209

Injection safety 210

Medical devices and equipment 213

E-health for health care delivery 213

Overview of health technologies in sub-Saharan Africa 216

Editorial Reviews

“Good functioning health systems call for sound management. This book is a must-read for all actors engaged in public health in Africa – governments, partners, practitioners, even the communities served.”

—Professor Eyitayo Lambo, MD and CEO

International Health and Management Consultants, Abuja, Nigeria; Former Minister of Health (2003–2007), Federal Republic of Nigeria

The book brings together practical approaches to the management of health services in Africa. It recognizes the importance of flexibility in the national political and social environment for successfully strengthening health systems. It provides valuable lessons and insights for policy makers and managers with a genuine interest in improving health in Africa.”

—Orvill Adams

Former Director, HRH; World Health Organization/HQ; Adjunct Professor, School of Epidemiology, Public Health and Preventive Medicine;

Faculty of Medicine, University of Ottawa, Ontario, Canada

“A brilliant insiders’ assessment of close to 70 years of efforts by WHO, national governments and their partners to improve health systems in Africa – with a clear indication of the way forward.”

—Professor Francis Omaswa

Executive Director, African Centre for Global Health and Social Transformation (ACHEST), Kampala, Uganda

“The authors have summarized the key challenges of, and documented illustrative successes in, contemporary health systems management in sub-Saharan Africa. Both decision makers and practitioners will find this resource invaluable.”

—David Sanders, MD

Emeritus Professor, School of Public Health, University of the Western Cape, Cape Town, South Africa

From the Publisher