Resources In Health Sector Research Articles

Climate finance opportunities for health and health systems.

Climate change poses significant risks to health and health systems, with the greatest impacts in low- and middle-income countries - which are least responsible for greenhouse gas emissions. The Conference of Parties 28 at the 2023 United Nations Climate Change Conference led to agreement on the need for holistic and equitable financing approaches to address the climate and health crisis. This paper provides an overview of existing climate finance mechanisms - that is, multilateral funds, voluntary market-based mechanisms, taxes, microlevies and adaptive social protection. We discuss these approaches' potential use to promote health, generate additional health sector resources and enhance health system sustainability and resilience, and also explore implementation challenges. We suggest that public health practitioners, policy-makers and researchers seize the opportunity to leverage climate funding for better health and sustainable, climate-resilient health systems. Emphasizing the wider benefits of investing in health for the economy can help prioritize health within climate finance initiatives. Meaningful progress will require the global community acknowledging the underlying political economy challenges that have so far limited the potential of climate finance to address health goals. To address these challenges, we need to restructure financing institutions to empower communities at the frontline of the climate and health crisis and ensure their needs are met. Efforts from global and national level stakeholders should focus on mobilizing a wide range of funding sources, prioritizing co-design and accessibility of financing arrangements. These stakeholders should also invest in rigorous monitoring and evaluation of initiatives to ensure relevant health and well-being outcomes are addressed.

PENGEMBANGAN POSKESTREN DALAM UPAYA MEMINIMALISIR BELANJA KESEHATAN SANTRI DI PESANTREN AINUL YAQIN

Abstract 
 According to Law Number 36 of 2009 concerning health, articles 4 and 5 state that everyone has the same opportunity to obtain access to health. The form of community empowerment in the health sector or Community Resource Health Efforts (UKBM) is a government breakthrough through Active Alert Village and Subdistrict Development since 2006 so that people can access basic health services easily and can develop UKBM and carry out community-based surveillance. Poskestren is one of the UKBMs that focuses on empowering Islamic boarding schools. The aim is for the Islamic boarding school community to understand the problems they face, plan and make efforts to solve them by utilizing local potential as stated in the Regulation of the Minister of Health of the Republic of Indonesia Number 1 of 2013 concerning Guidelines for the Implementation and Development of Islamic Boarding School Health Posts. Postkestren activities prioritize promotive and preventive services, without ignoring curative and rehabilitative aspects, with a spirit of mutual cooperation and assistance from local health centers assisted by postkestren cadres. The result of this service activity is a change in the level of knowledge and understanding of participants about postkestren after being given education. Based on the paired t-test, it is known that the t-value = -14.198, df = 29 and p-value = 0.000, it can be concluded that there is a statistical difference between the average pre-test score (before education) and the post average score -test (after education).

Adapting Economic Evaluation Methods to Shifting Global Health Priorities: Assessing the Value of Health System Inputs

ObjectivesWe highlight the importance of undertaking value assessments for health system inputs if allocative efficiency is to be achieve with health sector resources, with a focus on low- and middle-income countries. However, methodological challenges complicated the application of current economic evaluation techniques to health system input investments. MethodsWe undertake a review of the literature to examine how assessments of investments in health system inputs have been considered to date, highlighting several studies that have suggested ways to address the methodological issues. Additionally, we surveyed how empirical economic evaluations of health system inputs have approached these issues. Finally, we highlight the steps required to move toward a comprehensive standardized framework for undertaking economic evaluations to make value assessments for investments in health systems. ResultsAlthough the methodological challenges have been illustrated, a comprehensive framework for value assessments of health system inputs, guiding the evidence required, does not exist. The applied literature of economic evaluations of health system inputs has largely ignored the issues, likely resulting in inaccurate assessments of cost-effectiveness. ConclusionsA majority of health sector budgets are spent on health system inputs, facilitating the provision of healthcare interventions. Although economic evaluation methods are a key component in priority setting for healthcare interventions, such methods are less commonly applied to decision making for investments in health system inputs. Given the growing agenda for investments in health systems, a framework will be increasingly required to guide governments and development partners in prioritizing investments in scarce health sector budgets.

PENGEMBANGAN POSKESTREN DALAM UPAYA MEMINIMALISIR BELANJA KESEHATAN SANTRI DI PESANTREN AINUL YAQIN

According to Law Number 36 of 2009 concerning health, articles 4 and 5 state that everyone has the same opportunity to obtain access to health. The form of community empowerment in the health sector or Community Resource Health Efforts (UKBM) is a government breakthrough through Active Alert Village and Subdistrict Development since 2006 so that people can access basic health services easily and can develop UKBM and carry out community-based surveillance. Poskestren is one of the UKBMs that focuses on empowering Islamic boarding schools. The aim is for the Islamic boarding school community to understand the problems they face, plan and make efforts to solve them by utilizing local potential as stated in the Regulation of the Minister of Health of the Republic of Indonesia Number 1 of 2013 concerning Guidelines for the Implementation and Development of Islamic Boarding School Health Posts. Postkestren activities prioritize promotive and preventive services, without ignoring curative and rehabilitative aspects, with a spirit of mutual cooperation and assistance from local health centers assisted by postkestren cadres. The result of this service activity is a change in the level of knowledge and understanding of participants about postkestren after being given education. Based on the paired t-test, it is known that the t-value = -14.198, df = 29 and p-value = 0.000, it can be concluded that there is a statistical difference between the average pre-test score (before education) and the post average score -test (after education).

‘Q-Storming’ to identify challenges and opportunities for integrating health and climate adaptation measures in Africa

Climate factors influence the state of human health and wellbeing. Climate-related threats are particularly being experienced by vulnerable populations in Africa. A Question (Q)-Storming session was convened at an international climate adaptation conference. It promoted dialog among a diverse spectrum of researchers, climate and medical scientists, health professionals, national government officials, civil society, business, and international governing organizations. The session identified approaches for the effective integration of health within African national climate adaptation policies. Two organizations partnered to convene the session at the Adaptations Futures 2018 Conference in Cape Town. Q-storming (which is an inverse approach to brainstorming) was applied to extract ideas from all participants. Four topics were presented during the session: (i) adaptive capacities related to climate change and infectious diseases; (ii) adaptive capacity of African governments in relation to health and climate change; (iii) making climate science work to protect the health of vulnerable populations; and (iv) making climate-health research usable. Nine cross-cutting adaptation themes were generated (i.e. key definitions, adaptive capacity, health sector priorities, resources, operational capacities and procedures, contextual conditions, information pathways, and information utility). The Q-Storming approach was a valuable tool for improving the understanding of the complexities of climate-health research collaborations, and priority identification for improved adaptation and service delivery. Concerted recognition regarding difficulties in linking climate science and health vulnerability at the interface of practitioners and decision-makers is required, for better integration and use of climate-health research in climate adaptation in Africa. This can be achieved by innovations offered through Q-Storming.

Measuring the performance of health systems in Latin America

Abstract Background Efficiency has been identified as a key intermediate policy objective for Universal Health Coverage. Despite that, it was estimated that 20 to 40% of health sector resource utilization is wasteful globally. An efficient use of existing resources in healthcare is critical and a priority policy in sustaining positive health outcomes for the population. This study aimed to perform a longitudinal efficiency analysis was found concerning health systems specific to all the Latin America region over the last 13 years. Methods Health Adjusted Life Expectancy (HALE), Diphtheria Pertussis Tetanus (DPT)Immunization and Survivability Rate of under-5 were chosen as outputs, while Pooled Health Expenditure, Gross Domestic Product (GDP) per Capita and Population over 65 were selected as inputs. Cross sectional Data Envelopment Analysis using five-year averages and a longitudinal Data Envelopment Analysis (DEA) were performed creating several model iterations with our selected indicators. All the models had an output orientation, adjusted for variable returns to scale and incorporating a five-year time lag between inputs and outputs. Results Our cross-sectional DEA Analysis found that the best performing country ended up being Nicaragua, followed by Cuba, Honduras, Costa Rica and Chile, while the countries performing the worst were Suriname, Venezuela and Guatemala. When observing efficiency scores behaviors longitudinally, all our model iterations result in the region decreasing efficiency in their health systems by 2.5% to 6.9% from 2000 to 2013, depending on the model chosen. Conclusions The study reveals that all countries in Latin American can improve their health systems efficiency performance to different extents. Latin America reduced total health system productivity between 2000 and 2013. Further studies are required to uncover the extent and causes of this regression. A similar analysis in Europe may be warranted and could aid policy making. Key messages • Overall efficiency in Latin American health systems has decreased by 3% to 7% over the last thirteen years. • Nicaragua, Cuba, Honduras and Costa Rica seem to have the most efficient health systems in the region, whereas Venezuela and Guatemala are the least efficient.

Capital Budgeting and Health Sector Performance in South West Nigeria

This study examined the relationship between budgeted capital and health sector performance in South West Nigeria. The study adopted statistical tools to analyse the data that were sourced from the approved budget estimates of the six South Western States. The descriptive statistics showed that on an average level, all the selected capital expenditures contributed approximately 99.9% to their capital budgetary allocations. Jarque-Bera test statistics reveals that capital budgetary allocation and all other variables were normally distributed. The covariance analysis showed that all the variables were significant with a positive association with capital budgetary allocation. Based on the findings, the study concludes that there is poor allocation of budget for health sector and water resources, while expenditure on environmental sanitation was significant at 5%. The study recommends that government should increase the intervention budgetary allocation to health sector for general well-being of citizens.

A Survey to Understand Necessity of Administrative Training of A Medical Teacher

Medical teacher has an indispensible role in teaching, patient care and research work. However, it is difficult to define the array of roles of a medical teacher. For the various roles, leadership, managerial and administrative skills of teachers are crucial. But usually medical teachers are not trained to enhance these skills. This survey aims to assess perception of medical teachers about their administrative and managerial skills beyond academic work, research and patient care. A questionnaire was designed, pilot-tested and administered to all faculty members (N=197). A self-administered questionnaire containing 20 items was developed on Google form. 146 responses were recorded on Google form (response rate of74 %) and analysed. The majority of the teachers' were of the opinion that there is a need to improve their individual administrative skill. However, in the absence of formal faculty administrative training programs in the college, most of the teachers indicated that their administrative skills are currently being improved through sporadic informal community of practice involving interested colleagues and modelling identified good teachers. A well-structured training to departmental administrative requirements shall have positive impact not only on academics, research and patient care but also on job satisfaction among medical teachers. This will also lead to better utilization of various resources in health sector. While setting up separate health administration department in each medical college will lead to better management of multidisciplinary challenges of healthcare. This will further decrease the administrative burden on Medical teachers.

Prevention of violence against women and girls: A cost-effectiveness study across 6 low- and middle-income countries.

BackgroundViolence against women and girls (VAWG) is a human rights violation with social, economic, and health consequences for survivors, perpetrators, and society. Robust evidence on economic, social, and health impact, plus the cost of delivery of VAWG prevention, is critical to making the case for investment, particularly in low- and middle-income countries (LMICs) where health sector resources are highly constrained. We report on the costs and health impact of VAWG prevention in 6 countries.Methods and findingsWe conducted a trial-based cost-effectiveness analysis of VAWG prevention interventions using primary data from 5 randomised controlled trials (RCTs) in sub-Saharan Africa and 1 in South Asia. We evaluated 2 school-based interventions aimed at adolescents (11 to 14 years old) and 2 workshop-based (small group or one to one) interventions, 1 community-based intervention, and 1 combined small group and community-based programme all aimed at adult men and women (18+ years old). All interventions were delivered between 2015 and 2018 and were compared to a do-nothing scenario, except for one of the school-based interventions (government-mandated programme) and for the combined intervention (access to financial services in small groups). We computed the health burden from VAWG with disability-adjusted life year (DALY). We estimated per capita DALYs averted using statistical models that reflect each trial’s design and any baseline imbalances. We report cost-effectiveness as cost per DALY averted and characterise uncertainty in the estimates with probabilistic sensitivity analysis (PSA) and cost-effectiveness acceptability curves (CEACs), which show the probability of cost-effectiveness at different thresholds. We report a subgroup analysis of the small group component of the combined intervention and no other subgroup analysis. We also report an impact inventory to illustrate interventions’ socioeconomic impact beyond health. We use a 3% discount rate for investment costs and a 1-year time horizon, assuming no effects post the intervention period. From a health sector perspective, the cost per DALY averted varies between US$222 (2018), for an established gender attitudes and harmful social norms change community-based intervention in Ghana, to US$17,548 (2018) for a livelihoods intervention in South Africa. Taking a societal perspective and including wider economic impact improves the cost-effectiveness of some interventions but reduces others. For example, interventions with positive economic impacts, often those with explicit economic goals, offset implementation costs and achieve more favourable cost-effectiveness ratios. Results are robust to sensitivity analyses. Our DALYs include a subset of the health consequences of VAWG exposure; we assume no mortality impact from any of the health consequences included in the DALYs calculations. In both cases, we may be underestimating overall health impact. We also do not report on participants’ health costs.ConclusionsWe demonstrate that investment in established community-based VAWG prevention interventions can improve population health in LMICs, even within highly constrained health budgets. However, several VAWG prevention interventions require further modification to achieve affordability and cost-effectiveness at scale. Broadening the range of social, health, and economic outcomes captured in future cost-effectiveness assessments remains critical to justifying the investment urgently required to prevent VAWG globally.

The solutions for developing health human resources in Ho Chi Minh City

This research paper addresses issues related to health, health care, human resources in health sector, characteristics of human resources for health, the need to develop a health workforce, analyzes criteria for evaluating human resources for health in terms of both quantity, quality and structure of human resources; the current situation of human resource development in the health sector in the Ho Chi Minh city from the perspective of quantity, quality and structure of human resources in the state, non-state, and foreign-invested sectors. From the analysis of the current situation of human resource development for health in the city, the author has assessed the situation of human resource development, shortcomings and limitations such as the size and quality of professional training. health care is not commensurate with the current socio-economic development, the salaries of doctors and nurses are still low and not commensurate with their efforts, especially in the public sector, brain drain,... and suggested recommendations and solutions such as expanding training scale and controlling training quality, ensuring human resource structure distributed by line, improving motivation for human resources. health care, investing in physical and technical infrastructure serving medical examination and treatment, improving the management capacity of the leadership team in order to develop human resources in the health sector in the coming period.

Trends in rural fiscal decentralisation in India’s Karnataka state: a focus on public health

For decades, decentralisation reforms have been seen as a powerful instrument by health policy advocates to improve health sector performance in developing countries. In India, the 73rd Constitutional Amendment introduced in 1992 called for strengthening the fiscal autonomy and service delivery capacity of rural local governments. This paper explores how decentralised governance influences public health sector resource allocation, equity and efficiency in rural Karnataka. For this, the authors analysed administrative data published by the Karnataka state government to create tailored standardised performance measures that capture the degree of local governments’ fiscal discretion in implementing public health programmes from 2011–18 at the district level. The findings highlight sector-specific differences in fiscal autonomy, ranging from high local discretion over funds in the nutrition sector to very limited discretion in the medical and public health sector. They also show that decentralised public health funding is not well-targeted to areas of greatest need in Karnataka

Health Sector Resource Mapping in Malawi: Sharing the Collection and Use of Budget Data for Evidence-Based Decision Making.

In 2011, the Ministry of Health in Malawi developed and institutionalized a resource-tracking process, known as resource mapping (RM), to collect information on planned funding flows across the health sector to support resource allocation and mobilization decisions. We analyze the RM process and tools and describe key uses of the data for health financing decision making to achieve universal health coverage (UHC). We applied a case study approach, written as a collaboration between policy makers who have led the RM process in Malawi and the implementation team who have developed tools, collected data, and reported results over the period. It draws on our experiences in conducting RM in Malawi to document the RM process and data, key uses of data, implementation challenges, and lessons learned. We conducted a gray literature review to understand rounds of RM in which we did not participate. Finally, we conducted a search of published literature to situate our work in the international health resource-tracking literature. The RM exercise in Malawi is iteratively designed around the needs of the end users and policy priorities of the government, which in turn drives institutionalization of the exercise. We describe 4 ways in which RM data has been used, including national and district planning and budgeting; prioritization and coordination of existing funds by estimating resource availability; mobilization of new resources by conducting financial gap analysis against costed national strategic plans; and generation of evidence to support the national response to the coronavirus disease 2019 pandemic. To achieve UHC goals in Malawi, RM has equipped the government and development partners with critical data used for resource mobilization and coordination decisions. Lessons learned from RM in Malawi may be applicable to other countries starting or refining their own health resource-tracking exercise.

Effect of the Health Promotion Plan on the Performance of Hospitals: Evidences from East of Iran

Background: Hospitals are considered as the most central and resource-consuming units in the healthcare system. They use from 50 to 80% of public expenditures. As hospitals become more efficient, the better the allocated resources in health sector will be used.
 Objectives: The aim of this study was to assess hospitals’ efficiency in South Khorasan using the Pabon Lasso model.
 Methods: In this quasi-experimental and time-series study, we investigated the efficacy of South Khorasan hospitals during 2010 - 2018 (before and after the implementation of the health reform plan). All public hospitals in South Khorasan province were enrolled. Data including bed occupancy rate (BER), bed turnover (BT), and patient length of stay (LOS) were collected from hospitals in summer 2018 and analyzed using SPSS, version 21.
 Results: The means of the Pabon Lasso performance indicators for eight years were 74.4% for bed occupancy rate, 89.9 times for bed turnover, and 3.01 days for the length of stay. The coefficient of occupancy index after the implementation of the health reform plan was 5.7% higher than before, the bed turnover index increased 4.1 times, and the average length of stay increased by 0.08 day. On average, 35% of the hospitals were located in region 1, while 38% in region 2, 21% in Region 3, and 6% in Region 4 in the Pabon Lasso Diagram.
 Conclusions: Only 21% of the hospitals were in the region 3 of the Pabon Lasso Diagram, which is the desirable region for the efficiency of hospitals. This situation is not desirable and acceptable for hospitals. To increase productivity, interventions are required, and health planners and authorities need to apply economic tools for the improvement of this situation.

Barriers and Associated Factors to the Use of Routine Health Information for Decision-Making Among Managers Working at Public Hospitals in North Shewa Zone of Oromia Regional State, Ethiopia: A Mixed-Method Study.

BackgroundRoutine health information (RHI) systems are vital for the acquisition of data for health sector planning, monitoring, and evaluation, patient management, health education, resource allocation, disease prioritization, and decision-making. Use RHI for decision-making is low in Ethiopia. Thus, the study aimed to assess barriers and associated factors to the use of RHI among managers working at public hospitals in North Shewa, Ethiopia.MethodsA facility-based mixed-method study was conducted from May to June 2020. A total of 102 randomly selected managers were included in the survey and six key informant interviews were done. Data were collected using a structured self-administered questionnaire and interview guide by trained data collectors. Data were entered into Epi-info version 7.1 and transferred into SPSS version 23 for further statistical analysis. Both bivariate and multivariable logistic regression analyses were performed. In the multiple logistic regression analysis, a less than 0.05 P-value was considered statistically significant. The odds ratio along with a 95% confidence interval was estimated to measure the strength of the association. Thematic analysis was done for key informant interview data.ResultsIn this study, the level of RHI use for decision-making was 71.6% (95% CI: 61.8%, 79.4%). According to the multivariable logistic regression analysis, training on health information system (AOR = 0.28, 95% CI: 0.08–0.98) and supportive supervision (AOR = 0.27, 95% CI: 0.09–0.78) were found significantly associated with the use of RHI for decision-making. Moreover, the lack of staff motivation and computer and data analysis skills were the major reasons for not using RHI.ConclusionThree-fourth of the managers working at public hospitals used RHI for decision-making. Training on health information systems and supportive supervision were factors associated with the use of RHI. Therefore, training of managers and the provision of supportive supervision were highly recommended.

A Narrative Synthesis Review of Out-of-Pocket Payments for Health Services Under Insurance Regimes: A Policy Implementation Gap Hindering Universal Health Coverage in Sub-Saharan Africa.

Background: "Achieve universal health coverage (UHC), including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all" is the Sustainable Development Goal (SDG) 3.8 target. Although most high-income countries have achieved or are very close to this target, low- and middle-income countries (LMICs) especially those in sub-Saharan Africa (SSA) are still struggling with its achievement. One of the observed challenges in SSA is that even where services are supposed to be "free" at point-of-use because they are covered by a health insurance scheme, out-of-pocket fees are sometimes being made by clients. This represents a policy implementation gap. This study sought to synthesise the known evidence from the published literature on the ‘what’ and ‘why’ of this policy implementation gap in SSA. Methods: The study drew on Lipsky’s street level bureaucracy (SLB) theory, the concept of practical norms, and Taryn Vian’s framework of corruption in the health sector to explore this policy implementation gap through a narrative synthesis review. The data from selected literature were extracted and synthesized iteratively using a thematic content analysis approach. Results: Insured clients paid out-of-pocket for a wide range of services covered by insurance policies. They made formal and informal cash and in-kind payments. The reasons for the payments were complex and multifactorial, potentially explained in many but not all instances, by coping strategies of street level bureaucrats to conflicting health sector policy objectives and resource constraints. In other instances, these payments appeared to be related to structural violence and the ‘corruption complex’ governed by practical norms. Conclusion: A continued top-down approach to health financing reforms and UHC policy is likely to face implementation gaps. It is important to explore bottom-up approaches – recognizing issues related to coping behaviour and practical norms in the face of unrealistic, conflicting policy dictates.

Tracking health sector priority setting processes and outcomes for human resources for health, five-years after political devolution: a county-level case study in Kenya

BackgroundHealth sector priority setting in Low and Middle-Income Countries (LMICs) entails balancing between a high demand and low supply of scarce resources. Human Resources for Health (HRH) consume the largest allocation of health sector resources in LMICs. Health sector decentralization continues to be promoted for its perceived ability to improve efficiency, relevance and participation in health sector priority setting. Following the 2013 devolution in Kenya, both health service delivery and human resource management were decentralized to county level. Little is known about priority setting practices and outcomes of HRH within decentralized health systems in LMICs. Our study sought to examine if and how the Kenyan devolution has improved health sector priority setting practices and outcomes for HRH.MethodsWe used a mixed methods case study design to examine health sector priority setting practices and outcomes at county level in Kenya. We used three sources of data. First, we reviewed all relevant national and county level policy and guidelines documents relating to HRH management. We then accessed and reviewed county records of HRH recruitment and distribution between 2013 and 2018. We finally conducted eight key informant interviews with various stakeholder involved in HRH priority setting within our study county.ResultsWe found that HRH numbers in the county increased by almost two-fold since devolution. The county had two forms of HRH recruitment: one led by the County Public Services Board as outlined by policy and guidelines and a parallel, politically-driven recruitment done directly by the County Department of Health. Though there were clear guidelines on HRH recruitment, there were no similar guidelines on allocation and distribution of HRH. Since devolution, the county has preferentially staffed higher level hospitals over primary care facilities. Additionally, there has been local county level innovations to address some HRH management challenges, including recruiting doctors and other highly specialized staff on fixed term contract as opposed to permanent basis; and implementation of local incentives to attract and retain HRH to remote areas within the county.ConclusionDevolution has significantly increased county level decision-space for HRH priority setting in Kenya. However, HRH management and accountability challenges still exist at the county level. There is need for interventions to strengthen county level HRH management capacity and accountability mechanisms beyond additional resources allocation. This will boost the realization of the country’s efforts for promoting service delivery equity as a key goal – both for the devolution and the country’s quest towards Universal Health Coverage (UHC).

Baseline, Cross-sectional Survey of Knowledge, Attitudes, and Practices Related to Efficient Use of Government Resources in the Health Sector in Malawi.

Misuse of government resources is a challenge within the health sector that can be addressed by increasing public demand for accountability, reporting suspected misuse of resources, and other client-driven changes. This study was led by the USAID/Health Communication for Life Project to inform the design of social accountability communication messages and interventions. The study also established baseline data on Malawians' knowledge, attitudes, and practices related to efficient use of government resources in the health sector. This baseline, formative research study used a non-experimental, cross sectional survey design. Sampling for the mobile survey was conducted using the random digit dialing technique. Data were collected via mobile phone using interactive voice response technology. Our sample included 1,425 respondents, 67% of whom were male and 33% were female. Respondents were mostly 35 years old or younger, with more than half of female respondents reporting their age as 18-24 years. Our findings indicate that Malawians believe misuse of government resources is pervasive in Malawi. Seventy percent of men and nearly 60% of women reported having noticed, found, or seen drugs believed to be from a government health facility being sold elsewhere. Few respondents who had observed or experienced misuse of government health sector resources reported the incident. When asked the likelihood that they would report a request for a bribe, gift, or favor in exchange for health services in the future, 68% of respondents said they would report it. Social and behavior change communication could serve a key role in motivating those who are aware of misuse of public sector health resources to report the issues they observe and providing them with the information needed to follow through. Further research is needed to understand the best approaches to mitigate underlying factors that drive misuse of resources and underreporting.

Safe Reintroduction of Cardiovascular Services During the COVID-19 Pandemic: From the North American Society Leadership

The coronavirus disease-2019 (COVID-19) pandemic has led to marked global morbidity and mortality ([1–3][1]). There have been appropriate but significant restrictions on routine medical care to comply with public health guidance on physical distancing and to help preserve or redirect limited

Safe Reintroduction of Cardiovascular Services During the COVID-19 Pandemic: From the North American Society Leadership

The coronavirus disease-2019 (COVID-19) pandemic has led to marked global morbidity and mortality ([1–3][1]). There have been appropriate but significant restrictions on routine medical care to comply with public health guidance on physical distancing and to help preserve or redirect limited

Public Financial Management Perspectives on Health Sector Financing and Resource Allocation in Ethiopia

In this paper, we discuss Ethiopia’s approach to health delivery, trends in health financing trends, focusing on the financing arrangements and expenditure management systems through which health funding is allocated from various internal and external sources. The paper reviews Ethiopia’s public financial management system to identify challenges and opportunities to improve domestic resource mobilization for health and resource allocation within the health sector. With the imminent transition away from external donor support that Ethiopia faces due to economic growth, the paper explores the sources of fiscal space for health in Ethiopia to sustain progress in the health sector through a deep dive of the sources of health financing through tax and non-tax revenues, additional borrowing, future aid prospects, and better fiscal discipline and expenditure efficiency.