“This product, developed through a collaborative learning process among primary health care leaders and implementers from around the globe, shares practical lessons and recommendations for countries that are improving the financing and delivery of primary health care,” said Amanda Folsom, a senior program director at R4D. “As countries recover from the COVID-19 pandemic, they are re-focusing on primary health care as the backbone of resilient health systems. This product provides a timely look at how countries in different contexts are innovating to deliver essential health services through primary care networks and highlights country demand for more cross-country learning, evidence generation, and support to improve primary health care.”

To strengthen primary health care financing and delivery and improve access to and use of care, a growing number of countries are implementing primary care networks (PCNs). Primary care networks are networks of collaborating primary care providers working together to provide quality primary care to patients in a coordinated approach.

Because PCNs are still emerging as a well-understood model for organizing primary care, R4D and its partners recognized a unique opportunity for knowledge generation and cross-country collaborative learning about how to design, implement, and scale up PCNs.

Beginning in 2020, in partnership with R4D, the JLN and PHCPI launched a COP to facilitate action-oriented peer learning with an emphasis on primary care. The learning exchanges focused on transforming the health system to prioritize primary health care, using data in COVID-19 response and recovery, and implementing and measuring the performance of primary care networks.

The COP enabled a broader community of learners to follow and learn from three country teams implementing PCNs — Colombia, Ghana, and Kenya— and share knowledge and experiences with their peers. The COP also produced a resource, Transforming Primary Health Care Delivery and Financing Through Primary Care Networks, that highlights key takeaways on how to successfully implement PCNs.

Over three years during the COVID-19 pandemic, the COP worked to support countries to transform their PHC systems to be more responsive and resilient. Participant feedback and results suggest that the COP provided an important and valued forum for cross-country experience-sharing and learning. The experience also highlighted the need for deeper and sustained systematic learning initiatives for countries to continue to improve PHC to better meet the needs of their populations. Collaborative learning that is demand-driven, responsive, and tailored to implementers’ needs can help countries accelerate their progress.

• To read the full report, click here.
• To read the Spanish version of the report, click here.

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About Results for Development
Results for Development (R4D) is a leading non-profit global development partner. We collaborate with change agents — government officials, civil society leaders and social innovators — supporting them as they navigate complex change processes to achieve large-scale, equitable outcomes in health, education and nutrition. We work with country leaders to diagnose challenges, co-create, innovate and implement solutions built on evidence and diverse stakeholder input, and engage in learning to adapt, iterate and improve. We also strengthen global, regional and country ecosystems to support country leaders with expertise, evidence, and innovations. R4D helps country leaders solve their immediate challenges today, while also strengthening systems and institutions to address tomorrow’s challenges. And we share what we learn so others around the world can achieve results for development too. www.R4D.org

Photo © Irene Angwenyi, USAID/Kenya.

The post How to design, implement and scale up primary care networks — a new resource appeared first on Results for Development.

At Results for Development (R4D), Ms. Gates is a program associate on the Strategic Purchasing Africa Resource Center (SPARC) and Cross-Programmatic Efficiency Analysis (CPEA) teams. In this role, she assists in program management, country engagement and the facilitation of collaborative learning. She also works with R4D’s coaching team on management of the Experts Database.

Prior to joining R4D full-time, Ms. Gates interned with the R4D-led Health Systems Strengthening Accelerator (Accelerator), the Primary Health Care Performance Initiative (PHCPI) and R4D’s Frontier Health Market (FHM) Engage team to provide support in program management and day-to-day responsibilities.

Ms. Gates holds a BS in public health with an emphasis in environmental/occupational health and a minor in international development from Brigham Young University.

The post Rachel Gates appeared first on Results for Development.

Ms. Koch is the senior program associate on the Evidence to Policy team. She provides technical and program management support to cross-sectoral initiatives related to policy change including the Partnership for Evidence and Equity in Responsive Social Systems (PEERSS) initiative, a global partnership supporting evidence-informed policymaking in social systems.  

Before joining R4D, Ms. Koch consulted on a mid-term evaluation of a USAID–funded health systems strengthening project in Madagascar, specifically leading the qualitative data collection and analysis to draft key findings and inform program recommendations. Additionally, as a member of CARE’s humanitarian team, she contributed to thought leadership on gender-responsive humanitarian response. She supported the research and publication of policy briefs, including drafting the “Humanitarian Response Reform” chapter in CARE’s Building Forward COVID-19 response report addressing gender inequality in the humanitarian sector. Prior to this role, Ms. Koch served as a Peace Corps volunteer in Cameroon where she taught English and implemented girl’s empowerment programs.  

Ms. Koch holds a master’s degree in Development Practice (MDP) with a Gender Justice concentration from Emory University and a BA in Africana Studies from The College of William and Mary. She is a native English speaker and speaks fluent French. 

The post Rebekah Koch appeared first on Results for Development.

As director Centre for Sustainable Health Innovations, Singapore she leads the tripartite InnovationS for UHC Collaborative to catalyze south-south dialogues around leveraging low-cost technological innovations and new models of healthcare in Asia and Africa. She is also co-founder of the Mutual Learning Platform for Mixed Health Systems launched in 2020 in response to the COVID 19 pandemic that convenes the private sector and public health stakeholders for evidence sharing and building interventional capacity for stronger health systems. Her projects on health technology includes a partnership with the Consortia of Affordable Technologies (CamTech) which mentors and seed-funds early stage social impact health innovations in Asia and Africa and the Grand Challenges Grant winner, the Biodiaspora Partnership that tracks and models infectious and vector borne disease through human movement patterns.

As senior public health scientist at the Public Health Foundation of India, she directs the Universal Health Coverage Initiative part of one of India’s seminal health policy exercises on health system reform. She was secretariat director for the government of India’s High Level Expert Group recommendations on universal health coverage, part of the country’s 12th Five Year Plan.

Dr. Balasubramaniam has authored several reports, policy briefs as well as peer-reviewed publications over her career as both a clinician and researcher. She works closely with municipal and state governments regionally and served on a taskforce on primary healthcare constituted Ministry of Health and Family Welfare, government of India and was a member of the technical review group on urban health constituted by the Ministry of Urban Development. She serves on the editorial board of the International Journal of Health Governance, was recently appointed to the editorial board of the newly launched Oxford Open Journal of Infrastructure and Health, and is regional editorial advisor to Oxford University Press’s Healthy Cities and Communities Encyclopaedia. Dr. Balasubramaniam holds visiting faculty positions at the National University of Singapore and the Keenan Research Centre, Toronto, Canada. She is a frequent advisor on health systems and policy to numerous multi-bi lateral organizations including WHO, IDRC Canada, the European Commission, the World Bank, the Wellcome Trust, USAID, DfID, and the Bill & Melinda Gates Foundation.

The post Priya Balasubramaniam appeared first on Results for Development.

• Continuous Demand Assessment
• Multi-stakeholder Collaboration
• Strengthen Accountability Mechanisms
• Promote Continuous Shared Learning
• Provide Health Financing Technical Support

This report looks at the project’s achievements in an effort to gauge how well ACS met its five aforementioned main objectives in the countries it was supporting. To do so, this report will look at how the project has performed in each country team (Benin, Botswana, Namibia, and Uganda). In other words, what would be the value-add of the ACS project in each of the countries if support stopped at end of November 2021.

The post ACS Achievements: Findings from Cross-Project Review and Stakeholder Validation appeared first on Results for Development.

• Continuous Demand Assessment
• Multi-stakeholder Collaboration
• Strengthen Accountability Mechanisms
• Promote Continuous Shared Learning
• Provide Health Financing Technical Support

Due to the inherently demand-driven nature of the ACS approach, project activities and outcomes are likely to vary across different locations and time. While ACS is guided by an overarching theory of change, there is a high potential that outcomes from the project may be unanticipated, requiring inductive methodologies to surface evidence regarding these outcomes. As the project closes in March 2022, project leadership sought to undertake an evaluation that would identify significant outcomes from the project and provide evidence and validation for how these outcomes occurred and in what context.

This evaluation report presents the methodology and findings from one evaluation of the ACS project.

The post ACS Project Outcome Harvesting Evaluation Report appeared first on Results for Development.

This special issue was spearheaded by R4D as the core technical partner of the Strategic Purchasing Africa Resource Center (SPARC), a resource hub that aims to strengthen strategic purchasing expertise in sub-Saharan Africa. R4D initially incubated SPARC, and SPARC is now led by Amref Health Africa.

Strategic purchasing is about which health services should be prioritized for public funding, from which providers, and how much providers should be paid to deliver these services. Strategic purchasing enables policymakers to direct health funds to priority populations and services, and to create incentives to health providers aligned with population health needs. It’s widely recognized as a critical lever for facilitating progress on universal health coverage.

“Strategic purchasing is being recognized in Africa as a means to use limited resources better, but the context specific evidence has been limited so far,” said Agnes Gatome-Munyua, M.P.H., associate director at R4D and contributor to the HSR special issue. “It is widely accepted that more public funding is needed to expand access to health services and reduce out-of-pocket payments, but the ability to raise public resources for health in sub-Saharan Africa is limited. At the same time, greater health spending doesn’t always translate into better health outcomes. That’s where strategic purchasing comes in. We’re excited to share this body of research to add to a growing area of work and expertise on the continent around strategic purchasing.”

Before now, evidence on strategic purchasing from Africa has been limited to mostly examining performance-based financing (PBF) schemes, which are often limited in scope, or from Ghana, Kenya, Nigeria, and Rwanda, and focused on insurance-based systems. The special issue offers more varied examples, on different health financing arrangements from countries such as Benin, Burkina Faso,  Cameroon, Tanzania and Uganda. These papers show how each country approaches strategic purchasing differently, and that progress can be made in any health system context.

Dr. Cheryl Cashin, a managing director at R4D and contributor to the HSR special issue, added: “This special issue of the Health Systems and Reform journal spotlights the appetite for more strategic health purchasing evidence that countries can learn from and adapt for their own contexts. It also highlights the deep bench of African experts who have been working to implement and refine strategic purchasing functions in their countries and grow the evidence base through collaborative learning — when groups of learners work together to solve a problem, complete a task, and create new knowledge.”

To read the latest papers, see the table below. We will update the table with links to the papers after they’re published. Ms. Gatome-Munyua and Dr. Cashin also authored an introductory blog to this series, which provides a useful overview. Read it now.

Contents of The Health Systems and Reform (HSR) special issue on “Making Progress on Strategic Health Purchasing in Africa”

Introduction

• Commentary: Introduction to the Special Issue on Making Progress on Strategic Health Purchasing in Africa by Agnes Gatome-Munyua and Cheryl Cashin

Framing the Conversation on Strategic Purchasing

Policy Reports

• Why is Strategic Health Purchasing Critical for Universal Health Coverage in sub-Saharan Africa? By Agnes Gatome-Munyua, Isidore Sieleunou, Sory Orokia and Cheryl Cashin
• The Strategic Health Purchasing Progress Tracking Framework: A Practical Approach to Describing, Assessing, and Improving Strategic Purchasing for Universal Health Coverage by Cheryl Cashin and Agnes Gatome-Munyua

Article

• Applying the Strategic Health Purchasing Progress Tracking Framework: Lessons from Nine African Countries by Agnes Gatome-Munyua, Cheryl Cashin, Isidore Sieleunou, Edwine Barasa, Freddie Ssengooba, Kabore Issa, Sabine Musange, Osoro Otieno, Suzan Makawia, Christelle Boyi, Eugenia Amporfu, Uchenna Ezenwaka

Commentary

• Collaborative Learning to Advance Knowledge and Practice of Strategic Health Purchasing in sub-Saharan Africa by Agnes Gatome-Munyua, Charlemagne Tapsoba and Cheryl Cashin

Strategic Purchasing Country Papers

Articles

• Strategic Purchasing Arrangements in Uganda and Their Implications for Universal Health Coverage by Elizabeth Ekirapa-Kiracho, Aloysius Ssennyonjo, Richard Ssempala, Chrispus Mayora, Freddie Ssengooba
• The landscape of Strategic Health Purchasing for Universal Health Coverage in Burkina Faso: Insights from Five Major Health Financing Schemes by Joël Arthur Kiendrébéogo, Charlemagne Tapsoba, Yamba Kafando, Issa Kaboré, Orokia Sory, S. Pierre Yaméogo
• Strategic health purchasing in Nigeria: Investigating governance and institutional capacities within the Formal Sector Social Health Insurance Scheme and tax-funded health services in Nigeria by Uchenna Ezenwaka, Agnes Gatome-Munyua, Chikezie Nwankwor, Nkechi Olalere, Nneka Orji, Uchenna Ewelike, Benjamin Uzochukwu, Obinna Onwujekwe
• Strengths and weaknesses of strategic health purchasing for universal health coverage in Rwanda by Stella Umuhoza Matutina, Sabine Musange, Alypio Nyandwi, Parfait Uwaliraye, Regis Hitimana
• Strategic Health Purchasing Progress Mapping: A spotlight on Ghana’s National Health Insurance Scheme by Eugenia Amporfu, Peter Agyei-Baafour, Anthony Edusei, Jacob Novignon, Vivian Addo-Cobbiah

Key Issues on Strategic Purchasing in Sub-Saharan Africa

Commentary

• The Government Budget: An Overlooked Vehicle for Strategic Health Purchasing by Aloysius Ssennyonjo, Otieno Osoro, Freddie Ssengooba, Chrispus Mayora, Elizabeth Ekirapa, Richard Ssempala and Danielle Bloom

Article

• Is performance-based financing a pathway to strategic purchasing in sub-Saharan Africa? A synthesis of the evidence by Dennis Waithaka, Cheryl Cashin, Edwine Barasa

The Evidence on Strategic Purchasing and Impact on System Improvements

Articles

• Has Strategic Purchasing Led to Improvements in Health Systems? A Narrative Review of Literature on Strategic Purchasing by Fred Matovu, Agnes Gatome-Munyua and Richard Sebaggala
• The Effects of Health Purchasing Reforms on Equity, Access, Quality of Care, and Financial Protection in Kenya: A narrative review by Evelyn Kabia, Jacob Kazungu, Edwine Barasa
• Strategic Health Purchasing in Nigeria: Investigating governance and institutional capacities within federal tax-funded health schemes and the formal sector social health insurance programme by Obinna Onwujekwe, Chinyere Ojiugo Mbachu, Chinyere Okeke, Uchenna Ezenwaka, Daniel Ogbuabor, Charles Ezenduka

Commentary

• Can Strategic Health Purchasing Reduce Inefficiency and Corruption in the Health Sector? The Case of Nigeria by Prince Agwu and Obinna Onwujekwe

Conclusion

• SPARC the Change: What the Strategic Purchasing Africa Resource Center Has Learned about Improving Strategic Health Purchasing in Africa by Cheryl Cashin, Nathaniel Otoo, George Kimathi and Danielle Bloom

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About Results for Development
Results for Development (R4D) is a leading non-profit global development partner. We collaborate with change agents — government officials, civil society leaders and social innovators — supporting them as they navigate complex change processes to achieve large-scale, equitable outcomes in health, education and nutrition. We work with country leaders to diagnose challenges, co-create, innovate and implement solutions built on evidence and diverse stakeholder input, and engage in learning to adapt, iterate and improve. We also strengthen global, regional and country ecosystems to support country leaders with expertise, evidence, and innovations. R4D helps country leaders solve their immediate challenges today, while also strengthening systems and institutions to address tomorrow’s challenges. And we share what we learn so others around the world can achieve results for development too.

The post Largest body of strategic purchasing research from the African continent appeared first on Results for Development.

On February 8, 2022,  the JLN and the Accelerator hosted a final webinar to:  

• Articulate key actions countries and partners will need to take to improve coordination of the COVID-19 response as we enter the third year of the global pandemic 
• Highlight the key lessons and promising practices identified through the Collaborative’s work over the past year 
• Reflect on the impact and value of the Collaborative to improve national responses to pandemics   

The webinar included a moderated dialogue on the best practices for an effective national response to pandemics in low- and middle-income countries.  

Opening Remarks  

• Professor Samba Sow, World Health Organization Special Envoy for COVID-19 and Director General of the Center for Vaccine Development in Mali 

Moderators 

• Professor Raquel Duarte of the University of Porto in Portugal 
• Professor John Ryu of Yonsei University in South Korea 

Panelists 

• Dr. Beza Aseffa – Ministry of Health, Ethiopia 
• Dr. Kwame Amponsa-Achiano – Ghana Health Service, Ghana  
• Ms. Meboh Abuor – Council of Governors, Kenya 
• Mr. Steven N Kabwama – Makerere University School of Public Health, Uganda 

The post Coordinating Multi-sectoral, Multi-level Pandemic Responses appeared first on Results for Development.

On February 2nd, the Health Systems Strengthening Accelerator and the Joint Learning Network for Universal Health Coverage (JLN) co-hosted a webinar that brought together UHC and rehabilitation leaders to exchange country experiences with rehabilitation, including how (or whether) it is integrated within health systems and UHC strategies, and the effects of the COVID-19 pandemic.

Speakers included R4D Senior Program Director Nathan Blanchet, World Health Organization Director of Sensory Functions, Disability, and Rehabilitation Dr.Alarcos Cieza, Joint Learning Network Steering Group Convener Dr. Adolfo Martinez Valle, Medical Rehabilitation Therapists Regional Board of Nigeria (MRTB) CEO Dr. Akanle Olufunke, and rural physiotherapist Maryke Bezuidenhout.

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Prior to R4D, Mr. Rogers was a logistics coordinator for Transaver LLC working primarily with its francophone client in Quebec to facilitate their logistical and transportation needs. He also volunteered with the Alliance for Citizen Engagement (ACE) where he assisted in guiding the research wing of the organization, published research briefs covering global health, the World Health Organization, the US role in international development, and the impact of climate change on health. He presented on climate change and health at ACE’s Climate Migration 2022 Conference.

Mr. Rogers studied public administration, international relations, and global health while working full-time in the logistics industry. He holds a graduate certificate in global health studies and a master’s in public administration from the State University of New York at Albany. He has a BA in history from St. John Fisher College. He is a native English speaker, speaks fluent French and conversational Spanish.

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