The covid-19 pandemic: research and health development in the World Health Organisation Africa region

Concerns have been expressed about the view point of WHO AFRO concerning research for health in the African Region. WHO AFRO considers research a critical component in the improvement of health in the Africa region. Ensuring the effectiveness of our strategies, policies and programmes requires evidence. In the context of the ongoing COVID-19 outbreak, WHO research interests cover key areas of the response. The WHO AFRO consider research as critical in our efforts at protecting people against health emergencies and pandemics like the COVID-19 and ensuring universal access to proven interventions. In view of this, the WHO has taken steps to strengthen capacity for research in the region. The results of these efforts may take time to manifest but will surely do as we persist in our drive, with support from our partners

Improving Health Systems to increase technical efficiency

"In recent years; extensive effort has been applied to improve efficiency of health systems functioning. Efficiency attempts to maximise outputs for available resources. Coventionally; this is either technical or allocative efficiency. Allocative efficiency looks at how resources are distributed among competing programmes/activities; while technical efficiency looks at how well these resources are used within the programme/activity. While technical efficiency considers only the process of production; allocative efficiency introduces the notion that society is concerned not just with how an output is produced; but also with what outputs and what balance of outputs are to be produced. It is achieved when it is impossible to improve the welfare of anyone without reducing the welfare of someone else through a change in the output combination (Lipsey and Chrystal; 19995); i.e. the achievement of a Pareto-Optimal state (Donaldson et al 1994). Much effort in efficiency improvements in health has focussed on improving allocative efficiency; allocation of resources among programmes/activities. Techniques of economic evaluation; which allows comparison of choices between alternative health interventions and programmes have been used. Attempts that look at technical efficiency; how these resources are utilised within a programme/activity; have featured less prominently. Health managers directly; or implicitly assume that health interventions are being produced at least possible cost; with the difference in outcomes between competing health programmes ""almost always"" dominating any differences in cost arising from different levels of resource use within a programme/activity. This article seeks to review the feasibility and potential impact of improvements of resource use within a programme/activity on key policy issues; with the aim to provide insight into ways to free up resources to finance health needs""."

Nutrition Policy and Strategy: Opportunities for Programming and Impact: A Study Commissioned under the District Health Services Project

The nutrition status of Uganda; particularly children and pregnant/lactating women and the poor is inadequate; despite having a relatively high per capita availability of food. There are nutrition and agricultural institutions; policies and plans in different Ministries. There is also a national food and nutrition council; which is a multi-sectoral body that advises Government on matters pertaining to food and nutrition policy; a Uganda national Plan of Action for Nutrition; the Uganda National Plan for Action for Children; and Uganda was a signatory to the World Declaration and the Plan for Action for Nutrition at the Rome 1992 International Conference on Nutrition. In spite of all these; previous efforts to fight the nutrition problem seem not to be effective. 38of the Under-5's are stunted (UDHS; 1995); and; it is estimated; based on UNICEF (2000) and UDHS (1995) and 153 children die each hour from malnutrition related causes. Malnutrition is a multi-sectoral problem; and the multiple linkages have to be taken into consideration if a suitable and sustainable impact is to be made. There was therefore a need to critically review the institutional framework; policies and plans related to nutrition and food; and propose how these can be improved to reverse the poor nutrition situation in the country. As a (JSI) to carry out an assessment of the current nutrition status and programs in Uganda and recommend a national nutrition policy and stragegy that will reduce the high levels of malnutrition. The objectives of the exercise were to: - Define and quantify the malnutrition burden in the country through review of available information and identify main causes; - Evaluate existing policies; strategies and interventions in order to identify strengths and weaknesses. Propose a national strategy and interventions for addressing the malnutrition burden in Uganda. This should include recommendations on an essential package of nutrition services which cover clinical and public health interventions for use at health facilities. - Review the institutional framework and mechanisms for nutrition interventions; as well as the linkages with other sectors; institutions or agencies concerned with nutrition and make recommendations as to how these can be strengthened. - Suggest a sustainable mechnanism for the acquisition and utilisation of resources necessary to implement the proposed nutrition intervention plan. - Draft a costed short term and long term nutrition intervention plan of action. - Impact basic skills to counterparts and key officials in the Ministry of Health

How operational are district health systems? Estimation of available resources

A study to assess the operationality of district health systems was carried out between February and May 2001. Operationality is defined as the state of the existing and functional structures and managerial processes that enable the provision of essential health care to the population. This was not an assessment of the performance of the district; but rather the availability of functional inputs required for health care delivery. A health care system is assessed in terms of the structures/inputs it has for health care provision; the processes used to convert these inputs into favorable products; and the outcomes that are achieved as a result of the actions of the system. The performance of a health system is a function of the available inputs; and the efficiency with which these inputs are utilized. We need to first determine the presence of inputs; before determining how these are used. The level of inputs into the health care system has not been determined. Different programs have some ideas as to the amount of input they have; but no study has ever comprehensively looked at inputs into te district system. This study quantifies the inputs into a score that can be compared over time and whithin districts for inter district comparisons. The study was very comprehensive; and this paper is a condensation of the findings. We explored thestructures/inputs that avail the users with an opportunity to receive adequate care. These features do not tel us whether the users are receiving quality care; but rather; they tell us whether there is an increased / decreased likelihood of receiving quality care. We do not explore the level of functioning of the inputs analysed; but rather the presence or absence of these inputs. Efficiency with which these inputs are utilized is a second stage of this analysis