Selected Topics - Health Sector Development

• Centre for Health Assets Australasia
  Hosted by the Faculty of the Built Environment at UNSW, the vision of the Centre for Health Assets Australasia is..." to be the Australasian focal point for research and knowledge creation in health facility asset management and to contribute to the delivery of healthcare of the highest quality in Australia and New Zealand through research outcomes which enhance the design, procurement and management of health facilities."
• UNSW Research Centre on Ageing and Retirement

Events

• School of Public Health and Community Medicine, UNSW - Upcoming Events

Global policies and related documents

• Policy Brief: Cross-Border Health Care in Europe
  "This new policy brief provides a review of current information and issues relating to cross-border health care in Europe. The publication gives an overview of current patterns of patient mobility, then goes on to examine the legal framework for mobility, financial implications, approaches to quality monitoring and patients' rights and liability issues."

Reports, guidelines and projects

• A comparative analysis of the changes in nursing practice related to health sector reform in five countries of the Americas
  The objective of this study conducted by Edilma B Guevera and Elnora P Mendias was to identify changes in nursing practices and nursing practice environment that have occurred with implementation of health sector reform in five countries in America: Argentina, Brazil, Colombia, Mexico and the United States.
• Approaches to health care quality regulation in Latin America and the Caribbean
  This paper was prepared by the Quality Assurance and Workforce Development Project (QAP) for the Latin America and Caribbean Regional Health Sector Reform Initiative. It aims to provide insights into the challenges facing current initiatives in healthcare quality regulation and provide direction for the future.
• Assessment of National Institutes of Health Centers of Excellence Programs, Institute of Medicine of the National Academies
  This report presents the results of a one year study conducted by the Institute of Medicine of the US National Academies that examined the use of research centre grants by the National Institutes of Health. The study focused on the criteria and procedures used in deciding to adopt the use of centres, how they are designed and administered, comparisons with other mechanisms of research support, their impacts and costs, and how they are evaluated as a mechanism
• Challenging Health System Sustainability: Understanding Health System Performance of Leading Countries
  "This report is a follow-up to the Understanding Health Care Cost Drivers and Escalators report March 2004. The purpose of this report is to provide insights for key decision makers on the performance, productivity and management practices of health care in other OECD countries. In this report we focus on Switzerland, Sweden, Spain, France, Australia and New Zealand. The report identifies best practices in these countries and gives possible directions for further analysis".
• Corruption and Good Governance in the Senegalese Health Care System
  This site outlines an International Development Research Centre, Canada project that seeks to document and qualitatively analyse the impact that corruption has had, and is having, in the health sector, and more specifically in health facilities, in Senegal. It includes links to various articles published in national and daily newspapers discussing the project.
• Defining a minimum data set and related indicators for use with the system of health accounts in the European Union (PDF) 128pg
  "This report summarises interim results of work to develop indicators focusing on four dimensions of health system performance: sustainability, efficiency, effectiveness, and equity, by applying the method of the System of Health Accounts (SHA). It is proposed that these indicators form a Minimum Data Set to use with the SHA. To this end Eurostat has provided grant funding for two closely related projects within the work programme of the Core Group on Health Care Statistics of the Partnership Health..."
• Distribution of Major Health Risks: Findings from the Global Burden of Disease Study (PDF) 12pg
  Anthony Rodgers, Majid Ezzati, Stephen Vander Hoorn, Alan D. Lopez, Ruey-Bin Lin, Christopher J. L. Murray,This report published in PLOS Medicine Vol.1, Issue 1, 2004 concludes that many major global risks are widely spread in a population, rather than restricted to a minority. Population-based strategies that seek to shift the whole distribution of risk factors often have the potential to produce substantial reductions in disease burden.
• Governance and Corruption in Public Health Care Systems
  This Working Paper by Maureen Lewis from the Center for Global Development examines the factors that influence health care delivery in the developing world. It emphasises the role that good governance can have on stemming problems such as absenteeism, corruption and mismanagement and the important role this can have on health care delivery.
• HCO Working Papers - "Cost Effectiveness and Health Sector Reform" by Philip Musgrove 1993
• Health care priority setting: principles, practice and challenges
  Craig Mitton, Centre for Healthcare Innovation & Improvement, B.C. Research Institute for Children's and Women's Health, and Dept. of Health Care and Epidemiology, University of British Columbia, Vancouver, Canada; Cam Donaldson, Centre for Health Services Research, School of Population & Health Sciences and Business School (Economics), University of Newcastle upon Tyne, UK; Cost Effectiveness and Resource Allocation 2004, 2 - “Health organizations the world over are required to set priorities and allocate resources within the constraint of limited funding. However, decision makers may not be well equipped to make explicit rationing decisions and as such often rely on historical or political resource allocation processes. One economic approach to priority setting which has gained momentum in practice over the last three decades is program budgeting and marginal analysis (PBMA).”
• Health in all Policies: Prospects and Potentials
  "This volume, published in the context of the Finnish Presidency of the European Union (EU), aims to highlight how and why the health dimension can and should be taken into account across all government sectors. Particular emphasis is placed on the unique mandate and obligation of the EU to protect health in all its policies. The topic is explored from the perspectives of available methods and different levels of policy-making, and examples are included from specific policy areas and health issues."
• Health Outcomes Core Library Project
  The National Information Center on Health Services Research and Health Care Technology, National Library of Medicine, AcademyHealth, Washington, DC - July 14, 2004 - “The National Library of Medicine (NLM) contracted with AcademyHealth to develop a core list of books, journals, Web sites and bibliographic databases and a desired list of books and journals in the field of health outcomes. Both lists are intended to serve as a guide for librarians who want to develop a health outcomes collection.”
• Health sector development and disease control in India by Farhad Ali, Panorama Online, TakingITGlobal
• Health systems, health and wealth – Assessing the case for investing in health systems (Summary)
  "The complex relationships between health systems, health and wealth are represented in a conceptual framework that features a dynamic interaction between health systems and health, health systems and wealth, and health and wealth. The model also shows that these three elements together impact on the central goal of societal well-being. Finally, it recognizes that the socioeconomic and political context is crucial in determining how all of these interact with each other ... The framework can help policy-makers to: systematically review how health systems produce health, impact on wealth creation and help to create societal well-being; marshal the evidence for discussions with other sectors; and make the case for investment in health systems." Also available in French, German and Russian.
• Health Systems in East Asia: What can Developing Countries Learn from Japan and the Asian Tigers
  This World Bank Report asserts that the health systems of Japan and the Asian Tigers -- Hong Kong (China), the Republic of Korea, Singapore, and Taiwan (China) -- and the recent reforms to them provide many potentially valuable lessons to East Asia's developing countries.
• Health systems in transition: country profiles
  HiTs are country-based profiles that provide a description of each health care system and of reform initiatives in progress or under development. They are published by WHO in conjunction with the European Observatory on Health Systems and Policies
• Health systems in transition: learning from experience, European Observatory on Health Systems and Policies, 2004 WHO (PDF)153pg.
  “The period following the break-up of the Soviet Union has brought enormous political and socioeconomic change to the European Region. The health sector has not been spared the effects of transition, and the countries emerging from the process have each engaged to varying degrees in health system reform. It is at last possible to reach some judgment about how this process has unfolded, to identify successes and failures, and to understand better the scale and nature of the remaining challenges. This book draws on the experience and lessons learned in the Region over the past ten years of transition in key health systems areas, such as health care financing, the restructuring of hospitals, public health and gains in health system quality”.
• Improving Population Health: The Uses of Systematic Reviews
  Evidence-based public/population health differs from evidence-based medicine because it bridges complex systems and populations rather than homogenous patient populations. Many methodological issues confront those who produce and use systematic reviews relevant to public/population health, and concerted efforts are under way to improve the quality of systematic reviews in this area. This report includes case studies — ranging from tobacco control to binge drinking among college students to the mental health challenges of the Indian Ocean tsunami — that bear many lessons for those seeking to improve population health and suggest there is significant room to enhance the role of evidence in policymaking.
• Improving the world's health through national public health institutes
  Dealing with global health threats - including emerging infectious diseases such as SARS, behavioural risk factors such as tobacco use, and chronic disease- together with other challenges such as injury prevention and environmental health, requires considerable technical capability and experience. Many countries have found the critical mass of skills and knowledge that can be developed in a national public health institute (NPHI) to be crucially important in dealing with health problems on a population and community basis. A group of NPHls met in 2002 and 2004 to plan ongoing collaboration that focuses on common public health concerns. [author abstract] [Bulletin of the World Health Organization, February 2005, 83(2): 154-157]
• Integrated Care: A Guide for Policymakers
  "Based on the presentations and outcomes of research and discussions held on the occasion of a dedicated workshop at the European Social Network Conference (Edinburgh, 2005), this publication explores in clear and concise terms the rationale for introducing integrated care and its benefits for different users. It discusses the different levels at which integration must occur as well as the different types of integration. Further, it briefly analyses the various outcomes of integration on different users and providers. Finally, it describes specific challenges that policymakers face when they implement integrated care approaches as well as specific steps to be taken to overcome these challenges"
• Investing in Health: Benchmarking health systems
  “….The Nuffield Trust supported two fellowships in benchmarking, one at Cambridge (Dr Suzanne Wait) concentrating on the UK system, and one at the London School of Hygiene and Tropical Medicine (Dr Ellen Nolte), on the topic of international benchmarking. This report combines the findings of their research. Aimed at UK policy-makers and academics nationally and internationally, this report highlights key lessons learnt from the research carried out and identifies an agenda for future activities so as to develop approaches to (international) benchmarking in health further..."
• Monitoring and Evaluation of Decentralization Reforms in Developing Country Health Sectors (PDF) 107pg.
  Paul L. Hutchinson, Tulane University, Anne K. LaFond, John Snow Inc., Bethesda, MD: The Partners for Health Reformplus Project, September 2004 - "This work presents a conceptual framework for identifying key areas for evaluation of decentralization programs and the pathways – and potential barriers – by which decentralization can affect health systems. It also identifies ways to evaluate the impact of decentralization in achieving key objectives – improved efficiency, accessibility, equity, community participation and health status.” Also available in Spanish.
• New Trends in Development Evaluation
  “As the development framework changes, the evaluation function should also change accordingly. This process of reshaping the evaluation function is just beginning and it is impossible to foresee its final shape. Nevertheless, in order to stimulate debate, it is desirable to attempt to formulate the key trends.”
• Politics, Trust and Networks: Social Capital in Critical Perspective (PDF) 49pg
  Edited by Jane Franklin, with contributions from Stephen Baron; Fran Tonkiss; Mike Savage, Gindo Tampubolon; Alan Warde, Families & Social Capital ESRC Research Group, April 2004, London South Bank University - Families & Social Capital ESRC Research Group -an examination of the concept of social capital as an exchange commodity, through the ideas of networks of cooperation and trust. This document is situated, by its authors, within a wider conservative view of social change in which norms and values are assigned economic value
• Primary Care and Health System Performance: Adults’ Experiences In Five Countries
  Australia, Canada, New Zealand, the United Kingdom, and the United States, Commonwealth Fund in New York City, October 2004 - “This paper reports on a 2004 survey of primary care experiences among adults in Australia, Canada, New Zealand, the United Kingdom, and the United States. The survey finds shortfalls in delivery of safe, effective, timely, or patient-centered care, with variations among countries. Delays in lab test results and test errors raise safety concerns. Failures to communicate, to engage patients, or to promote health are widespread.”
• Primary care in the driver's seat: organisational reform in European primary health care
  Published by the European Observatory on Health Systems and Policy,"... this book is a study of the reforms of primary care in Europe as well as their impacts on the broader coordination mechanisms within European health care systems. It also provides suggestions for effective strategies for future improvement in health care system reform…..”
• Priority Areas for National Action: Transforming Health Care Quality
  "The U.S. Department of Health and Human Services and other groups in the public and private sectors should focus on 20 priority areas to improve health care quality and delivery, says a new report from the Institute of Medicine of the National Academies. Collective action in these areas could help transform the entire health care system. …”
• Public Health Capacity in Latin America and the Caribbean: Assessment and Strengthening
  This 2007 report by the Area of Health Systems Strengthening - Health Policies and Systems Unit of the Pan American Health Organization (PAHO/WHO) "was developed based on an in-depth literature review. Sources included country assessments, journal articles, survey data, publications, international cooperation documents and national policy documents in English, Spanish and Portuguese. While the literature review was comprehensive, the paper could have benefited from additional grey literature from the countries in the Region, which can be difficult to locate and obtain since it is not widely disseminated. One of the goals of circulating this paper is the identification of additional examples of strategies and interventions for monitoring, evaluating and strengthening public health capacities by the countries at the national and sub-national levels."
• Selecting Indicators for the Quality of Health Promotion, Prevention and Primary Care
  Martin Marshall, Sheila Leatherman, Soeren Mattke , OECD Health Promotion, Prevention and Primary Care Panel, OECD Organisation for Economic Co-operation and Development - October, 2004 - “This report presents the consensus recommendations of an international expert panel on indicators for mental health care. Using a structured review process, the panel selected a set of 27 indicators to cover the three key areas health promotion, preventive care and diagnosis and treatment in primary care.”
• Sometimes More Equal than Others: How Health Inequalities Depend on the Choice of Welfare Indicator
  Magnus Lindelöw, Centre for Study of African Economies, Oxford University, UK; World Bank Policy Research Working Paper 3329, 2004, The World Bank, Washington, DC, USA - a paper examining the correlation between measured inequality and the choice of welfare indicator
• State Profiles - Reforming the Healthcare System 2005
  State Profiles: Reforming the Health Care System 2005 is a compilation of major health system characteristics for each U.S. state, the District of Columbia, the Commonwealth of Puerto Rico, and the U.S. Virgin Islands. Published since 1990 by the AARP Public Policy Institute, the State Profiles series was developed to help guide policy discussions among public and private sector leaders in health care throughout the United States.
• Taking Forward the Health Systems Agenda: Report of a Consultation on Developing the Health Systems Action Network
  "The idea of a Health Systems Action Network (HSAN) was first proposed at a WHO-sponsored meeting in Montreux in April 2005, where it was thought that the creation of a Health Systems Action Network could intensify the global focus on health systems and broaden the range of participants in health systems strengthening. This report presents findings of a structured and systematic consultative process that aimed to document what stakeholders at the country and global level believe a Health Systems Action Network should do."
• The Evolving Role of Canada’s Family Physicians, 1992-2001
  Canadian Institute for Health Information, November 2004 - “The report provides national level results for a broadly-defined range of health care services, including office and hospital in-patient visits, mental health care, basic procedures (such as suturing and joint injection/aspiration), advanced procedures (like setting broken bones and intensive care/resuscitation), surgical services (such as appendectomies and tonsillectomies), anesthesia services, obstetrical care and assisting in the operating room. Data trends are examined across geographic (urban/rural) settings as well as for physician age and gender groups.”
• The Reform of the health care System in Portugal
  Stéphanie Guichard, Economics Department Working Papers NO. 405, OECD Organisation for Economic Co-operation and Development - October, 2004 -This paper examines n ambitious reform to increase efficiency of the Portuguese health care system launched in 2002.
• The US health system: an assessment and prospective directions for reform
  Elizabeth Docteur, Hannes Suppanz and Jaejoon Woo, Organisation for Economic Co-operation and Development, OECD, Working Paper No.350, February 2003 - “This paper assesses the performance of the United States health system in an international context and discusses potential directions for reform. The US health system is unique among OECD countries in its heavy reliance on the private sector for both financing and delivery of health care..."
• The World Bank Group: Operations Evaluation Department: Monitoring and Evaluation: Some Tools, Methods and Approaches A booklet providing a summary of a range of monitoring and evaluation techniques including performance indicators, the logframe approach, impact evaluation, and cost-benefit analysis
• The World Bank Group and Health Sector Development and Control in India
  An article examining the relationship between the World Bank Group and the Indian health sector
• The World Bank Group Document and Reports - Public management and essential public health functions
• The World Bank Group Document and Reports - Franchising in Health
• Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector
  "The end of 2007 marks an important step in the history of the HIV epidemic. According to the WHO, UNAIDS and UNICEF report Towards Universal Access: Scaling up Priority HIV/AIDS Interventions in the Health Sector, nearly a million more people (950,000) were receiving treatment with antiretroviral therapy (ART) in low- and middle-income countries by year’s end, bringing the total number of recipients to close to 3 million — a more than seven-fold increase over four years… Nevertheless, countries are still far from meeting universal access goals. An estimated 2.5 million people were newly infected with HIV in 2007, and overall, ART coverage still remains low — only 31% of people estimated to be in need of treatment in low- and middle-income countries were receiving it in 2007. Moreover, weak health systems and, in particular, a critical shortage of health-care personnel and a lack of long-term sustained funding threaten efforts to achieve universal access to HIV prevention, treatment and care. At the end of 2007, the gap between required and available funding was estimated to be US$ 8.1 billion. To meet universal access targets, funding will have to more than quadruple to US$ 35 billion in 2010 and to US$ 41 billion in 2015…."
• Translating Research into Practice: Speeding the Adoption of Innovative Health Care Programs
  Elizabeth H. Bradley, Tashonna R.Webster,Dorothy Baker, Mark Schlesinger, Sharon K. Inouye, Michael C. Barth, Kate L. Lapane, Debra Lipson, Robyn Stone, and Mary Jane Koren, Issue Brief July 2004 - The Commonwealth Fund - “For this study, the authors conducted case studies of four varied clinical programs to learn key factors influencing the diffusion and adoption of evidence-based innovations in health care. They found that the success and speed of the adoption/diffusion process depend on: the roles of senior management and clinical leadership; the generation of credible supportive data; an infrastructure dedicated to translating the innovation from research into practice; the extent to which changes in organizational culture are required; and the amount of coordination needed across departments or disciplines.”
• What Evidence is there about the effects of health care reforms on gender equity, particularly in health
  This report by Dr Piroska Östlin of the Karolinska Institutet is a synthesis of systematic reviews, narrative reviews and individual articles on the effects on health care reforms on gender equity, focusing on the impact of health policies.

Educational resources

• DFID Health Systems Resource Centre
  "The HSRC manages and provides technical assistance (TA), institutional development programmes and knowledge and information management services for the UK Department For International Development (DFID) in support of health policies that promote and respond to the health needs of the poorest communities in the developing world."
• Guidance on developing quality and safety strategies with a health system approach
  “…Quality and safety have been recognized as key issues in establishing and delivering accessible, effective and responsive health systems. The regionally shaped guidance document [published by WHO Regional Office for Europe - Copenhagen, Denmark in 2008] covers the development of national quality and safety strategies suited to local circumstances (from formulation to continual review and renewal in successive phases).”
• Health Systems 20/20 Health Systems Database
  This easy-to-use web-based tool compiles and analyses country data from multiple sources, provides charting options, and generates automated country fact sheets, helping users to assess the performance of the country’s health systems. The Health Systems Database draws data from publicly available and internationally comparable databases. Sources are publications from the World Health Organization (WHO), the World Bank, and the United Nations Children’s Fund (UNICEF). More recent data may be available from other sources including in-country sources. The user contribution section of this tool is designed to capture and share such information. The tool offers a user-friendly interface with several types of graphing and mapping features as well as a flexible data download system that provide key health systems information for any selected country. Comparisons with peer countries in the region and income group are provided, which allows for some benchmarking of performance, especially when international standards for benchmarking are not available. Country Health Systems Fact Sheets provide automated profiles, covering multiple health systems functions, for any low income or lower middle income country.
• The Health Systems Assessment Approach: A How-To Manual
  Edited by Mursaleena Islam in 2007 on behalf of the U.S. Agency for International Development in collaboration with Health Systems 20/20, Partners for Health Reformplus, Quality Assurance Project, and Rational Pharmaceutical Management Plus. Arlington, VA: Management Sciences for Health, “…this approach is designed to provide a rapid and yet comprehensive assessment of key health systems functions. The approach is organized around technical modules that guide data collection, and cover the following areas: Governance; Health financing; Health service delivery; Human resources; Pharmaceutical management; and Health information systems. Each module provides guidance for the user according to an indicator-based approach. The assessment approach is flexible and may encompass all modules for a more comprehensive view of the health care system or may focus on selected modules, according to the objectives of the assessment. A required core module provides basic background information on a country’s key health indices and other important data related to its economy, health system organization, and population.”
• The Eldis Gateway to Development Information
  "ELDIS is a gateway to information on development issues, providing free and easy access to wide range of high quality online resources."
• The Eldis Health Systems Database
  "There is a vast literature in the area of health. For your information we list here some of the key health systems-related databases, targeted search engines and online libraries to help you in locating materials"
• The Observatory of Human Resources in Health Sector Reforms: A definition
• Archives of Health-Sector-Development@JISCmail.ac.uk - Institute of Health Sector Development
  A Health Sector development archive providing information dating back to March 1999.

Organisations and Networks

UN and multinational

Government

• Health Sector Reform Programme of Trinidad and Tobago
  Trinidad and Tobago Ministry of Health - this site provides quite detailed information on the national health sector reform programme currently being effected in Trinidad and Tobago

Non Government

• Australian Development Gateway: Health
  “The Australian Development Gateway is a knowledge-sharing website, supporting people working in Asia Pacific countries to reduce poverty and promote sustainability. It is a mechanism for Australians and others in the Asia Pacific region to contribute knowledge and to engage in vigorous discussion. By accessing the ADG, people working in the field of development will be able to collaborate more effectively by sharing practical knowledge faster. They will be further empowered in developing policies and programs, researching issues, forming alliances and working towards sustainable growth and poverty reduction.”
• Asia Development Bank
  "ADB is a multilateral development finance institution dedicated to reducing poverty in Asia and the Pacific. Established in 1966, we are now owned by 63 members, mostly from the region...."
• Centre for Health and Equity: The Implications of Health Sector Reform for Reproductive Health<br>Examines the effect of health sector change on the quality of reproductive health options and services
• Health Systems Action Network
  As part of broader efforts to help countries achieve or exceed the health MDGs by 2015, HSAN’s mission is to stimulate informed and coordinated action by key partners, and to assist in the creation of expanded, comprehensive, and high-impact health systems strengthening activities in developing countries. In particular, HSAN focuses on aligning disease specific initiatives (such as STOP TB, the Global Fund to Fight AIDS, TB and Malaria, the Global Alliance for Vaccines, Roll Back Malaria etc) with health systems strengthening efforts.
• Institute for Health Sector Development
  "IHSD is a centre of expertise in international health and development, working to strengthen health systems and to improve health status, particularly in low and middle income countries. We are also increasingly active in the UK. Our aim is to identify innovative and effective approaches and to share experiences learned at global and country level"

Academic Institutions with particular focus in this area

• School of Public Health and Community Medicine, UNSW
• School of Public Health and Community Medicine, UNSW - Research

Key Conferences, conference and workshop reports

Coming conferences

Conference reports

• Health Services Restructuring: New Evidence and New Directions
  Health Services Restructuring: New Evidence and New Directions was organized by the John Deutsch Institute and the Institute for Research on Public Policy, Canada and held November 17-18, 2005 Kingston, Ontario. This site provides links to papers presented at the conference.

Journals, Newsletters, Forums

Bibliographies, Libraries

Public health bookshops

• Public Health bookshop