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Governance, organisation, financing and delivery of health systems

A key area of the work of HESA is health systems research, which seeks to generate knowledge about how societies organize themselves to achieve collective health goals.  Health systems research is a rapidly growing, multi-disciplinary field. 

Health systems research in HESA addresses the key health systems components of health financing, governance, and human resources.  The RESYST Consortium, for example, includes work on these three themes, but also seeks to examine the interactions among health system functions, the factors which influence effective implementation of health system policies, and the role of socio-political contexts at the national and global levels. 

HESA research has also examined how health systems change and innovate over time, for example, exploring health system responses to the growing burden of non-communicable chronic conditions and pluralistic health systems, particularly the role of the private sector. Our research seeks to promote methodological innovation, for example employing multi-method evaluations, action research, and methods for the evaluation of complex health system interventions.

HESA is the focal point for health systems research within the Faculty of Public Health and Policy. HESA staff are involved in international promotion of rigorous health systems research, including support to the first professional society on health systems, Health Systems Global.

List of projects (PI and other HESA staff collaborators):

Resilient and Responsive Health Systems (RESYST) | Kara Hanson (PI); Lucy Gilson (PI); Mylene Lagarde; Catherine Goodman; Jo Borghi | University of Cape Town; University of Witwatersrand; KEMRI Wellcome Trust Research Programme; Indian Institute of Technology Madras; Health Policy Research Group, University of Nigeria (Enugu); International Health Policy Programme; Ifakara Health Institute; Health Policy Systems Institute, Vietnam | Nigeria, South Africa, Tanzania, India, Thailand, Vietnam, Kenya

Universal coverage in Tanzania and South Africa (UNITAS) | Anne Mills (PI); Jo Borghi | University of Dar-es-Salaam; Ifakara Health Institute; Centre for Health Policy; University of Cape Town; University of KwaZulu Natal; Institute of Tropical Medicine Belgium | Tanzania; South Africa

Consortium for Health Policy & Systems Analysis in Africa (CHEPSAA) | Lucy Gilson (PI) | University of Cape Town; University of Dar es Salaam; University of Ghana; Tropical Institute of Community Health & Development Trust; College of Medicine of the University of Nigeria; University of Western Cape; University of Witwatersrand; University of Leeds, Karolinska; Schweizerizches Tropen-UND Public Health Institute | South Africa; Tanzania; Ghana; Kenya; Nigeria

New vaccines: from licensing to adoption | Anne Mills (PI); Sandra Mounier-Jack; Helen Burchett; Ulla Griffiths; Sergio Torres Rueda | Bangladesh (ICDDR,B); Cameroon; Ethiopia; Guatemala; Kenya; Mali; Rwanda; South Africa

Antimalarial drugs: market and supply chain research and policy recommendations (ACTwatch) | Kara Hanson (PI); Catherine Goodman; Ben Palafox; Sarah Tougher; Edith Patouillard | Benin; Democratic Republic of Congo; Cambodia; Madagascar; Nigeria; Uganda; Zambia

Good Health at low cost 2010: identifying factors, within health systems and the wider context, which influence health outcomes | Dina Balabanova (PI); Anne Mills; Ben Palafox; Loveday Penn-Kekana | IITM, India; ICDDRB, Bangladesh; MHRC, Ethiopia; IHPP, Thailand; Health Policy Analysis Group, Kyrgyzstan | India; Bangladesh; Ethiopia; Thailand; Kyrgyzstan

Investigating the role and influence of non-standard economic preferences on health workers' decisions in South Africa | Mylene Lagarde (PI) | Centre for Health Policy | South Africa

Cost-effectiveness of financial and non-financial incentives for the retention of physicians, Malawi | Kara Hanson (PI); Kate Mandeville | College of Medicine, University of Malawi | Malawi

Implications for the NHS of medical tourism | Richard Smith (PI) | York University | Global

Building sustainable capacity for research for health and its social determinants | Jo Borghi (PI); Edith Patouillard | Deutsche Gesellschaft fur Internationale Zusammenarbeit GIZ; IESE Business School; University of the Witwatersrand; University of Nairobi; Ifakara Health Institute; Fundacao Oswaldo Cruz; Instituto Nacional de Salud Publica; Universidad Nacional de Colombia; COHRED Group; University of Geneva | Germany; Spain; South Africa; Kenya; Tanzania; Mexico; Colombia; Switzerland

Donor aid tracking for MNCH (Countdown to 2015) | Jo Borghi (PI); Anne Mills (PI); Catherine Pitt; Giulia Greco; Melisa Martinez Alvarez; Christopher Grollman; Leonardo Arregoces; Paola Vargas Pastor| Global

Evaluation of a pilot P4P initiative in Tanzania | Jo Borghi (PI); Edith Patouillard; Giulia Greco | Ifakara Health Institute (IHI) | Tanzania

Evaluation of the impact of the NHIF MCH insurance, Tanzania | Jo Borghi (PI); Edith Patouillard; Frida Kasteng | Ifakara Health Institute (IHI) | Tanzania

The role of professional education and training in workforce migration | Richard Smith (PI); Gillian Styles | Ghana

IDEAS (Informed Decisions for Action) to improve Maternal and Newborn Health | Joanna Schellenberg (PI); Anne Mills; Neil Spicer; Lindsay Mangham; Kara Hanson | Last 10 Kilometers, Saving Newborn Lives, The Maternal and Newborn Health in Ethiopia partnership, Ethiopia; Society for Family Health, Nigeria; Better Birth, Manthan, Sure Start, India | Ethiopia, India, Nigeria

Evaluation of financial incentives for maternal health | Timothy Powell-Jackson  (PI) | Nepal

The impact of user fee removal policy in Zambia on health care utilisation, provider choice and out-of-pocket medical expenses | Aurelia Lepine (PI); Mylene Lagarde | Zambia

Financing and delivery of efficient, effective and equitable PHC systems in Ethiopia | Dina Balabanova (PI); Lindsay Mangham; Girmaye Dinsa | Ethiopia

Path to universal health coverage: understanding health system consequences of user-fee exemption | Fred Martineau (PI) | Sierra Leone

Studying health workers' incentives and accountability in Sierra Leone | Maria Bertone (PI); Mylene Lagarde | Sierra Leone

Increasing the uptake of health services in low-income countries: what can we expect from userfee removal & financial incentives | Aurelia Lepine (PI) | Senegal; Nigeria; South Africa

Equitable and sustainable health care financing in Timor Leste and Fiji | Lorna Guinness (PI) | Timor Leste; Fiji

District health management and health service delivery: evidence from India | Timothy Powell-Jackson (PI) | India

Maternal Evaluation Team | Catherine Goodman (PI); Timothy Powell-Jackson, Andreia Costa Santos; Shreya Pereira; Manon Haemmerli; Richard Iles, Sarah Tougher

Health systems strengthening in global health in China | Kara Hanson (PI), Melisa Martinez Alvarez; Dina Balabanova | China

Investigating the determinants of health worker performance | Mylene Lagarde (PI) | Senegal

Evaluation of the implementation, cost and long term impact of P4P of health services in Tanzania | Jo Borghi (PI) | Tanzania

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