Are we chasing the wind? Translating global health commitments to actions, for health results.

No abstract available.

eHealth or e-Chaos: The use of Digital Health Interventions for Health Systems Strengthening in sub-Saharan Africa over the last 10 years: A scoping review.

Background: Digital health solutions are a potent and complementary intervention in health system strengthening to accelerate universal access to health services. Implementing scalable, sustainable, and integrated digital solutions in a coordinated manner is necessary to experience the benefits of digital interventions in health systems. We sought to establish the breadth and scope of available digital health interventions (DHIs) and their functions in sub-Saharan Africa. Methods: We conducted a scoping review according to the Joanne Briggs Institute's reviewers manual and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Extension for Scoping Reviews (PRISMA-ScR) checklist and explanation. We retrieved data from the WHO Digital Health Atlas (DHA), the WHO e-Health country profiles report of 2015, and electronic databases. The protocol has been deposited in an open-source platform - the Open Science Framework at https://osf.io/5kzq7. Results: The researchers retrieved 983 digital tools used to strengthen health systems in sub-Saharan Africa over the past 10 years. We included 738 DHIs in the analysis while 245 were excluded for not meeting the inclusion criteria. We observed a disproportionate distribution of DHIs towards service delivery (81.7%, n = 603), health care providers (91.8%, n = 678), and access and use of information (84.1%, n = 621). Fifty-three percent (53.4%, n = 394) of the solutions are established and 47.5% (n = 582) were aligned to 20% (n = 5) of the system categories. Conclusions: Sub-Saharan Africa is endowed with digital health solutions in both numbers and distinct functions. It is lacking in coordination, integration, scalability, sustainability, and equitable distribution of investments in digital health. Digital health policymakers in sub-Saharan Africa need to urgently institute coordination mechanisms to terminate unending duplication and disjointed vertical implementations and manage solutions for scale. Central to this would be to build digital health leadership in countries within SSA, adopt standards and interoperability frameworks; advocate for more investments into lagging components, and promote multi-purpose solutions to halt the seeming "e-chaos" and progress to sustainable e-health solutions.

Data gaps towards health development goals, 47 low- and middle-income countries.

OBJECTIVE: To assess the availability and gaps in data for measuring progress towards health-related sustainable development goals and other targets in selected low- and middle-income countries. METHODS: We used 14 international population surveys to evaluate the health data systems in the 47 least developed countries over the years 2015-2020. We reviewed the survey instruments to determine whether they contained tools that could be used to measure 46 health-related indicators defined by the World Health Organization. We recorded the number of countries with data available on the indicators from these surveys. FINDINGS: Twenty-seven indicators were measurable by the surveys we identified. The two health emergency indicators were not measurable by current surveys. The percentage of countries that used surveys to collect data over 2015-2020 were lowest for tuberculosis (2/47; 4.3%), hepatitis B (3/47; 6.4%), human immunodeficiency virus (11/47; 23.4%), child development status and child abuse (both 13/47; 27.7%), compared with safe drinking water (37/47; 78.7%) and births attended by skilled health personnel (36/47; 76.6%). Nineteen countries collected data on 21 or more indicators over 2015-2020 while nine collected data on no indicators; over 2018-2020 these numbers reduced to six and 20, respectively. CONCLUSION: Examining selected international surveys provided a quick summary of health data available in the 47 least developed countries. We found major gaps in health data due to long survey cycles and lack of appropriate survey instruments. Novel indicators and survey instruments would be needed to track the fast-changing situation of health emergencies.

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