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Health systems bott...
Health systems bottlenecks and evidence-based district health planning : Experiences from the district health system in Uganda
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- Henriksson, Dorcus Kiwanuka, 1976- (författare)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH)
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- Swartling Peterson, Stefan, Professor (preses)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH)
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- Fredriksson, Mio, PhD (preses)
- Uppsala universitet,Institutionen för folkhälso- och vårdvetenskap
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- Waiswa, Peter, Associate Professor (preses)
- Makerere University College of Health Sciences
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- Hurtig, Anna-Karin, Professor (opponent)
- Umeå University
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(creator_code:org_t)
- ISBN 9789151300665
- Uppsala : Acta Universitatis Upsaliensis, 2017
- Engelska 71 s.
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Serie: Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 1651-6206 ; 1371
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Abstract
Ämnesord
Stäng
- In low-income countries where maternal and child mortality remains high, there is limited use of context-specific evidence for decision making and prioritization of interventions in the planning process at the sub-national level, such as the district level. Knowledge on the utility of tools and interventions to promote use of district-specific evidence in the planning process is limited, yet it could contribute to the prioritization of high-impact interventions for women and children.This thesis aims to investigate, in the planning process, the use of district-specific evidence to identify gaps in service delivery in the district health system in Uganda in order to contribute to improving health services for women and children.Study I evaluated the use of the modified Tanahashi model to identify bottlenecks for service delivery of maternal and newborn interventions. Study II and III used qualitative methods to document the experiences of district managers in adopting tools to facilitate the utilization of district-specific evidence, and the barriers and enablers to the use of these tools in the planning process. Study IV used qualitative methods, and analysis of district annual health work plans and reports.District managers were able to adopt tools for the utilization of district-specific evidence in the planning process. Governance and leadership were a major influence on the use of district-specific evidence. Limited decision space and fiscal space, and limited financial resources, and inadequate routine health information systems were also barriers to the utilization of district-specific evidence.Use of district-specific evidence in the planning process is not an end in itself but part of a process to improve the prioritization of interventions for women and children. In order to prioritize high impact interventions at the district level, a multifaceted approach needs to be taken that not only focuses on use of evidence, but also focuses on broader health system aspects like governance and leadership, the decision and fiscal space available to the district managers, limited resources, and inadequate routine health information systems.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Nyckelord
- District
- health systems
- decentralization
- evidence
- planning
- bottleneck analysis
- governance
- decision space
- health information systems
- maternal and newborn care
- child survival
- Uganda
- International Health
- Internationell hälsa
Publikations- och innehållstyp
- vet (ämneskategori)
- dok (ämneskategori)
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