ArticleBMJ open2016
Proposing evidence-based strategies to strengthen implementation of healthcare reform in resource-limited settings: a summative analysis.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 25 citations in OpenAlex.
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- Mapping digital health ecosystems in Africa in the context of endemic infectious and non-communicable diseases.NPJ digital medicine · 2023Article
- Human resource management in Ethiopian public hospitals.BMC health services research · 2022Article
- Strategic human resource management and performance in public hospitals in Ethiopia.Frontiers in public health · 2022Article
- Care of Older Persons in Eastern Africa: A Scoping Review of Ethical Issues.Frontiers in public health · 2022Article
- Pragmatic Management of Drug-Resistant Tuberculosis: A Qualitative Analysis of Human Resource Constraints in a Resource-Limited Country context-Ethiopia.International journal of public health · 2021Article
- Public health system challenges in the Free State, South Africa: a situation appraisal to inform health system strengthening.BMC health services research · 2020Review
- Health system readiness to support facilities for care of preterm, low birth weight, and sick newborns in Ethiopia: a qualitative assessment.BMC health services research · 2019Article
- Article
- Implementing health care reform: implications for performance of public hospitals in central Ethiopia.Journal of global health · 2018Article
- Beyond patient care: the impact of healthcare reform on job satisfaction in the Ethiopian public healthcare sector.Human resources for health · 2017Article
- Using the World Health Organization health system building blocks through survey of healthcare professionals to determine the performance of public healthcare facilities.Archives of public health = Archives belges de sante publique · 2017Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMany resource-limited countries have adopted and implemented healthcare reform to improve the quality of healthcare, but few have had much impact and strategies in support of these efforts remain limited. We aimed to explore and propose evidence-based strategies to strengthen implementation of healthcare reform in resource-limited settings.
designDescriptive and exploratory designs in two phases. Phase I involved assessing the effectiveness of the healthcare reform implemented in Ethiopia in the form of business process reengineering, with evidence compiled from healthcare professionals through a self-administered questionnaire; and phase II involved proposing strategies and seeking consensus from experts using Delphi method.
settingPublic hospitals in central Ethiopia.
participants406 healthcare professionals and 10 senior health policy experts.
findingsThe healthcare reform that we evaluated was able to restructure hospital departments into case teams, with the goal of adopting a 'one-stop shopping' approach. However, shortages of critical infrastructure, furniture and supplies and job dissatisfaction continued to hamper the system. The most important predictors that influenced implementation of the reform were financial resources, top management commitment and support, collaborative working environment and information technology (IT). Five strategies with 14 operational objectives and 67 potential interventions that could strengthen the reform are proposed based on their strategic priority, which are as follows: reinforce patient-centred quality of care services; foster a healthy and respectful workforce environment; efficient and accountable leadership and governance; efficient use of hospital financing and maximise innovations and the use of health technologies.
conclusionsEffective implementation of healthcare reform remained a challenge for governments in resource-limited settings. Resilient operational, clinical and governance functions of health systems, as well as a motivated and committed health workforce, are important to move healthcare reform processes forward. Political commitments at this juncture might be critical though there need to be a clear demarcation between political and technical engagements.
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