Evidence map›Paper›PMID 28005550›Full record

ArticleInternational journal of health policy and management2016

Analysing the Stewardship Function in Botswana's Health System: Reflecting on the Past, Looking to the Future.

Onalenna Seitio-Kgokgwe, Robin Dc Gauld, Philip C Hill, Pauline Barnett

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In one paragraph

Article in International journal of health policy and management, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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  3. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Onalenna Seitio-KgokgweMinistry of Health, Gaborone, Botswana.
Robin Dc GauldDepartment of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Philip C HillDepartment of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Pauline BarnettSchool of Health Sciences, University of Canterbury, Christchurch, New Zealand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn many parts of the world, ongoing deficiencies in health systems compromise the delivery of health interventions. The World Health Organization (WHO) identified four functions that health systems need to perform to achieve their goals: Efforts to strengthen health systems focus on the way these functions are carried out. While a number of studies on health systems functions have been conducted, the stewardship function has received limited attention. In this article, we evaluate the extent to which the Botswana Ministry of Health (MoH) undertook its stewardship role.

methodsWe used the WHO Health Systems Performance Assessment Frame (HSPAF) to guide analysis of the stewardship function of the Botswana's MoH focusing on formulation of national health policies, exerting influence through health regulation, and coalition building. Data were abstracted from published and unpublished documents. We interviewed 54 key informants comprising staff of the MoH (N = 40) and stakeholder organizations (N = 14). Data from documents was analyzed through content analysis. Interviews were transcribed and analyzed through thematic analysis.

resultsA lack of capacity for health policy development was identified. Significant policy gaps existed in some areas. Challenges were reported in policy implementation. While the MoH made efforts in developing various statutes that regulated different aspects of the health system, some gaps existed in the regulatory framework. Poor enforcement of legislation was a challenge. Although the MoH had a high number of stakeholders, the mechanisms for stakeholder engagement in the planning processes were weak.

conclusionProblems in the exercise of the stewardship function posed challenges in ensuring accountability and limited the health system's ability to benefit from its stakeholders. Ongoing efforts to establish a District Health System under control of the MoH, attempts to improve service delivery at a national level and political will to strengthen public-private engagement mechanisms are some of the prospects that can improve the MoH's stewardship function.

Indexed as

Delivery of Health CareGovernment AgenciesHealth PolicyPolicy MakingSocial ResponsibilityBotswanaCooperative BehaviorGovernment RegulationHealth PlanningHumansBotswanaHealth LegislationHealth PolicyHealth SystemStewardship

Identifiers

PMID28005550
PMCPMC5144877

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.