Development Goals Era Research Articles

The impact of a health systems strengthening initiative on child morbidity: The case of the Ghana Essential Health Interventions Program in rural northern Ghana.

BackgroundImproving child and maternal health remains a core objective of global health priorities, extending from the millennium development goal (MDG) era to the current focus on the Sustainable Development Goals (SGDs). This paper analyses the childhood morbidity effects of the Ghana Essential Heath Interventions Program (GEHIP), a community-based health systems strengthening in rural northern Ghana. GEHIP was a five-year embedded implementation science plausibility trial that implemented a set of health systems strengthening strategies and tested the proposition that their combined effect at the district, subdistrict and community levels could foster effective community engagement and thereby improve maternal and child health outcomes.MethodsA two stage random sample survey of reproductive-aged women residing in treatment and comparison districts at the GEHIP baseline and end line was used for Heckman Difference-in-differences (DiD) regression models for estimating the incremental effect of GEHIP exposure on three child morbidity conditions (diarrhea, fever and cough), as recalled by maternal respondents in the course of survey interviews.ResultsAfter controlling for child age and gender, maternal age, education, marital status, health insurance status, religion, ethnicity, occupation and household wealth index, regression results show that GEHIP had a statistically significant 45% reduction in fever (OR = 0.55, CI = 0.31–0.98) and 47% reduction in cough (OR = 0.53, CI = 0.30–0.94), over and above temporal reductions that prevailed in study districts. Although not significant, GEHIP also had 38% reduction in the incidence of diarrhea.ConclusionPrevious research has shown that GEHIP had a pronounced positive effect with a reduction in mortality. Our results show that household location in GEHIP districts also led to a significant reduction in morbidity due to cough and fever among under-five children. This association is a likely outcome of GEHIP’s impact on the accessibility of primary health care services. Results lend further support to the growing body of evidence that strengthening health systems in rural Africa through the provision of community-based strategies enhances prospects for achieving the United Nations child health SDGs.

How are global health policies transferred to sub-Saharan Africa countries? A systematic critical review of literature

BackgroundMost sub-Saharan Africa countries adopt global health policies. However, mechanisms with which policy transfers occur have largely been studied amongst developed countries and much less in low- and middle- income countries. The current review sought to contribute to literature in this area by exploring how health policy agendas have been transferred from global to national level in sub-Saharan Africa. This is particularly important in the Sustainable Development Goals (SDGs) era as there are many policy prepositions by global actors to be transferred to national level for example the World Health Organization (WHO) policy principles of health financing reforms that advance Universal Health Coverage (UHC).MethodsWe conducted a critical review of literature following Arksey and O’Malley framework for conducting reviews. We searched EBSCOhost, ProQuest, PubMed, Scopus, Web of Science and Google scholar for articles. We combined the concepts and synonyms of “policy transfer” with those of “sub-Saharan Africa” using Boolean operators in searching databases. Data were analyzed thematically, and results presented narratively.ResultsNine articles satisfied our eligibility criteria. The predominant policy transfer mechanism in the health sector in sub-Saharan Africa is voluntarism. There are cases of coercion, however, even in the face of coercion, there is usually some level of negotiation. Agency, context and nature of the issue are key influencers in policy transfers. The transfer is likely to be smooth if it is mainly technical and changes are within the confines of a given disease programmatic area. Policies with potential implications on bureaucratic and political status quo are more challenging to transfer.ConclusionPolicy transfer, irrespective of the mechanism, requires local alignment and appreciation of context by the principal agents, availability of financial resources, a coordination platform and good working relations amongst stakeholders. Potential effects of the policy on the bureaucratic structure and political status are also important during the policy transfer process.

Business resilience in the Sustainable Development Goals (SDGs) era: A conceptual review

Amidst the global COVID-19 pandemic, the term resilience has gained significant momentum in global news and management studies. Although scholars from different domains have investigated resilience, there is a need to provide clarity on its definitions and assessment (Anderson, 2015). This paper provides a conceptual review on resilience and explores business resilience as a framework to guide sustainability strategy by mitigating social and environmental risks. The study contributes to the literature on resilience and tabulates the key definitions of business resilience covered in a sample of 80 peer-reviewed articles and books (Hillmann & Guenther, 2021; McKnight & Linnenluecke, 2017). We challenge the existing literature on adaptive capacity models that are short in anticipating unprecedented operational disruptions. To build business resilience we argue for the adoption of the Sustainable Development Goals (SDGs). Given their strategic outlook until 2030, the SDGs offer a framework for corporate sustainability that helps decision-makers within organizations identify social and environmental risks and establish business strategies that build resilience and meet the expectations of a firm’s diverse stakeholders

Childhood health and the changing distribution of foreign aid: Evidence from Nigeria's transition to lower-middle-income status.

With sustained economic growth in many parts of the developing world, an increasing number of countries are transitioning away from the most subsidized development finance as they exceed income and other qualification requirements. Cross-country evidence suggests that Development Assistance Committee (DAC) donors view the crossing over of the World Bank's International Development Association (IDA) eligibility threshold to signal that a country needs less aid, with subsequent reductions in both IDA and other donors' concessional funding. Within the health sector, it is particularly important to understand the implications of these status changes for children under five years of age since improving early childhood health is critical to fostering health and social and economic development. Therefore, we examine the implications of the IDA transition by measuring the extent t which World Bank commitments—including both IDA and IBRD—are directed to infant and child health needs in Nigeria. Ordinary Least Squares (OLS) models were used in a difference-in-differences (DID) strategy to compare World Bank IBRD/IDA lending before and after the crossover to regions with varying initial levels of under-five and infant need. We find that the infant need orientation of World Bank aid has increased post-crossover. Conversely, alignment of World Bank commitments to regional child needs appears to have diminished after Nigeria crosses the IDA threshold. However, these effects are statistically insignificant and therefore provides inconclusive evidence. This research addresses an important policy question because the transition away from concessional funding mechanisms will result in difficult tradeoffs in allocating limited health resources; without providing conclusive evidence that crossover results in changes in need-based allocation, it does offer an essential path for future research. These results are directly relevant to policy debates about what we know and do not know about aid in transition and health. This research's value is especially important in the Sustainable Development Goal (SDG) era in understanding how donor exits could derail progress in health improvement.

Introduction – Managing Welfare Expectations and Social Change: Policy Responses in Asia

AbstractThe question whether Asian welfare types can be classified as distinctly ‘productivist’ has remained subject to lively debates: in East Asia, the recent implementation of social rights‐based public policy innovations – including working family support – as a response to rising inequalities, welfare expectations and accelerating social change has been well documented; similarly, South East Asian and South Asian economies have featured much more frequently in comparative social policy analysis as policymakers have sought to address persisting chronic poverty, a diminishing demographic dividend and burdensome epidemiological transitions via integrating human capital formation with social protection measures. Yet, far from a unifying convergence of these social policy trends in the post‐Millennium Development Goals era, the global perspective we take in this article suggests continued variation and difference, with a multiplicity of forms of globalizations encountered and/or engendered in diverse contexts. As a consequence, variegated and path‐dependent patterns of social development continue to persist across Asian economies. These findings, in turn, address major issues of our time, for they speak to the broader question of what analytical bases and research strategies can best reveal the complexities of (and interactions between) national, extra‐national and transnational drivers of welfare formation and development under contemporary but diverse conditions.

Assessing the Health Impact of Malaria Control Interventions in the MDG/Sustainable Development Goal Era: A New Generation of Impact Evaluations

Assessing the Health Impact of Malaria Control Interventions in the MDG/Sustainable Development Goal Era: A New Generation of Impact Evaluations

The Applicability of the Addis Ababa Action Agenda in Fragile Contexts—A Reflection

For the future of international cooperation in development, 2015 is a crucial year. As the Millennium Development Goals (MDGs) era comes to a close, UN members adopted the new universally applicabl...

The Astronomy of Africa's Health Systems Literature During the MDG Era: Where Are the Systems Clusters?

Growing international concern about the need for improved health systems in Africa has catalyzed an expansion of the health systems literature. This review applies a bibliometric procedure to analyze the acceleration of scientific writing on this theme. We focus on research published during the Millennium Development Goal (MDG) era between 1990 and 2014, reporting findings from a systematic review of a database comprised of 17,655 articles about health systems themes from sub-Saharan African countries or subregions. Using bibliometric tools for co-word textual analysis, we analyzed the incidence and associations of keywords and phrases to generate and visualize topical foci on health systems as clusters of themes, much in the manner that astronomers represent groupings of stars as galaxies of celestial entities. The association of keywords defines their relative position, with the size of images weighted by the relative frequency of terms. Sets of associated keywords are arrayed as stars that cluster as "galaxies" of concepts in the knowledge universe represented by health systems research from sub-Saharan Africa. Results show that health systems research is dominated by literature on diseases and categorical systems research topics, rather than on systems science that cuts across diseases or specific systemic themes. Systems research is highly developed in South Africa but relatively uncommon elsewhere in the region. "Black holes" are identified by searching for terms in our keyword library related to terms in widely cited reviews of health systems. Results identify several themes that are unexpectedly uncommon in the country-specific health systems literature. This includes research on the processes of achieving systems change, the health impact of systems strengthening, processes that explain the systems determinants of health outcomes, or systematic study of organizational dysfunction and ways to improve system performance. Research quantifying the relationship of governance indicators to health systems strengthening is nearly absent from the literature. Long-term experimental studies and statistically rigorous research on cross-cutting themes of health systems strengthening are rare. Studies of organizational malaise or corruption are virtually absent. Trend analysis shows the emergence of organizational research on specific priority diseases, such as on HIV/AIDS, malaria, and tuberculosis, but portrays a lack of focus on integrated systems research on the general burden of disease. If health systems in Africa are to be strengthened, then organizational change research must be a more concerted focus in the future than has been the case in the past.

Post‐MDGs and Africa's Development Conundrum

AbstractSince the 1960s, the international community and bodies have devised various mega‐plans to boost aid and help pull Africa out of its economic miasma. They all came to grief. In 2000, came another—the Millennium Development Goals—with the primary goal of eradicating extreme poverty and hunger by 2015. Only a handful of ‘small’ African countries are expected to make it. In the post‐Millennium Development Goals era, it is recommended that Africa should go back to the basics and do first things first by focusing on the traditional and informal sectors of the economy where the vast majority of the poor are found. It is pointless to talk about halving of poverty, for example, when Africa cannot feed itself. Copyright © 2015 John Wiley & Sons, Ltd.