Towards Resilient Health Systems in Sub-Saharan Africa: A Systematic Review of the English Language Literature on Health Workforce, Surveillance, and Health Governance Issues for Health Systems Strengthening.

Martin Amogre Ayanore,Margaret Gyapong,Norbert Amuna,Daniel Dramani Kipo-Sunyehzi,Richard Ofori-Asenso,Adam Awolu,Victor Mogre,Mark Aviisah,Jonathan Mawutor Gmanyami,Nuworza Kugbey

doi:10.5334/aogh.2514

Abstract

Background:Meeting health security capacity in sub-Saharan Africa will require strengthening existing health systems to prevent, detect, and respond to any threats to health. The purpose of this review was to examine the literature on health workforce, surveillance, and health governance issues for health systems strengthening.Methods:We searched PubMed, Science Direct, Cochrane library, CINAHL, Web of Science, EMBASE, EBSCO, Google scholar, and the WHO depository library databases for English-language publications between January 2007 and February 2017. Electronic searches for selected articles were supplemented by manual reference screening. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.Results:Out of 1,548 citations retrieved from the electronic searches, 31 articles were included in the review. Any country health system that trains a cadre of health professionals on the job, reduces health workforce attrition levels, and builds local capacity for health care workers to apply innovative mHealth technologies improves health sector performance. Building novel surveillance systems can improve clinical care and improve health system preparedness for health threats. Effective governance processes build strong partnerships for health and create accountability mechanisms for responding to health emergencies.Conclusions:Overall, policy shifts in African countries’ health systems that prioritize training a cadre of willing and able workforce, invest in robust and cost-effective surveillance capacity, and create financial accountability and good governance are vital in health strengthening efforts.

Highlights

In the wake of any health threat, the strength of the health system at the national and international levels is often tested [1, 2]
Health security at the national and the global level is said to exist if the following conditions are met: there is protection against any health threat, there are new adaptations and approaches to new health conditions that may arise, new actors are engaged, including military establishments, and synergy is drawn between foreign policy and public health at the national and global levels [5]
This review re-emphasizes the role of an effective cadre of health care workers, good investments in surveillance for decision making, and strong governance in health as critical for the success of any country health system

Summary

Introduction

In the wake of any health threat, the strength of the health system at the national and international levels is often tested [1, 2]. Meeting health security capacity in sub-Saharan Africa will require strengthening existing health systems to prevent, detect, and respond to any threats to health. The purpose of this review was to examine the literature on health workforce, surveillance, and health governance issues for health systems strengthening. Any country health system that trains a cadre of health professionals on the job, reduces health workforce attrition levels, and builds local capacity for health care workers to apply innovative mHealth technologies improves health sector performance. Building novel surveillance systems can improve clinical care and improve health system preparedness for health threats. Conclusions: Overall, policy shifts in African countries’ health systems that prioritize training a cadre of willing and able workforce, invest in robust and cost-effective surveillance capacity, and create financial accountability and good governance are vital in health strengthening efforts

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