Community of Practice Health Service Delivery (CoP HSD)

The CoP HSD functions under the umbrella of Harmonization for Health in Africa Initiative.

It aims to improve the performance of the local health systems (health districts) through quality health service provision.

It is an open network that brings together national and international health professionals, managers, policymakers, researchers and donors working in or for sub-Saharan Africa in particular and low- and middle-income countries in general.

It creates a platform where experts can share their experiences, knowledge, literature, and best practices in the field of health service delivery.

It helps local health actors to provide quality health care.

The expected results are the empowerment of local actors and the building of strong local health systems for better responding to the needs of the population.

Our tools, published in English and French are a blog, a Newsletter (also available in French), an online discussion forum, collaborative projects and research.

To become a ...

Primary health services at district level in South Africa: a critique of the primary health care approach

The rhetoric of primary health care philosophy in the district health system is widely cited as a fundamental component of the health transformation process in post-apartheid South Africa. Despite, South Africa´s progress and attempts at implementing primary health care, various factors still limit its success.

Non-communicable diseases in sub-Saharan Africa: a scoping review of large cohort studies

Non-communicable diseases (NCDs) cause a large and growing burden of morbidity and mortality in sub-Saharan Africa. Prospective cohort studies are key to study multiple risk factors and chronic diseases and are crucial to our understanding of the burden, aetiology and prognosis of NCDs in SSA. The aim of this study was to identify the level of research output on NCDs and their risk factors collected by cohorts in SSA.

Release of USAID ASSIST publications on promoting IPCHS in Mali and South Africa

The Integrated Health Services (formerly Service Delivery and Safety) department has collaborated with the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project to contribute to the development of integrated and people-centred health services (IPCHS) in different contexts and settings, including South Africa and Mali.

In Mali, work to improve the adoption of people-centred approaches in clinical consultations by health providers during pregnancy and delivery has been undertaken in collaboration with the Ministry of Health. In South Africa, collaboration has focused on HIV, and specifically, on how to promote patient-centredness in HIV services.

Reports describing both collaborations have been recently released.

Access the South Africa report here >>

Access the Mali report here >>

End-line Assessment of Integrated People-Centered Health Services in Nelson Mandela Metro Municipality, Eastern Cape Province, South Africa

Since 2013, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project has been working closely with the South African Department of Health (DOH) and its partners in five provinces to accelerate the reduction of morbidity and mortality through improving access, utilization, and satisfaction with essential HIV services. Drawing on its partnership with the World Health Organization (WHO) Service Delivery and Safety Department to promote people-centered care as an essential pillar of health service quality, ASSIST secured support from the USAID Office of Health Systems to pilot WHO’s global framework on integrated people-centered health services (IPCHS) in the Nelson Mandela Metropolitan District in Eastern Cape Province.

The pilot project consisted of a baseline assessment to harvest patient, provider, and decision maker perceptions and satisfaction regarding integration and patient centeredness in HIV services at onset of the project; training in quality improvement and IPCHS concepts and methodology; facility-based identification ...

A conceptual framework for capacity strengthening of health research in conflict: the case of the Middle East and North Africa region

In conflict settings, research capacities have often been de-prioritized as resources are diverted to emergency needs, such as addressing elevated morbidity, mortality and health system challenges directly and/or indirectly associated to war. This has had an adverse long-term impact in such protracted conflicts such as those found in the Middle East and North Africa region (MENA), where research knowledge and skills have often been compromised. This paper proposes a conceptual framework for health research capacity strengthening that adapts existing models and frameworks in low- and middle-income countries and uses the knowledge of the MENA context to contextualise them for conflict settings.

Non-communicable diseases in sub-Saharan Africa: a scoping review of large cohort studies

Non-communicable diseases (NCDs) cause a large and growing burden of morbidity and mortality in sub-Saharan Africa. Prospective cohort studies are key to study multiple risk factors and chronic diseases and are crucial to our understanding of the burden, aetiology and prognosis of NCDs in SSA. The aim of this study was to identify the level of research output on NCDs and their risk factors collected by cohorts in SSA.

Webinar: How to Use COVID-19 to Build Better UHC Systems in Africa

In discussion with Former President, H.E. Dr. Jakaya Kikwete, senior African officials, and other global health experts, this high-level webinar will focus on how the COVID-19 pandemic underscores a pressing need to implement UHC. Speakers will highlight how multi-sectoral collaboration is a pathway to achieving resilient, sustainable, and quality UHC in Africa by 2030.

At the event, Harvard Global Health Institute and The Access Challenge will launch the 2020 One by One UHC Report, “Africa Leads the Way: Harnessing Multi-sectoral Collaboration to Achieve UHC.”

This is a webinar for African leadership, communities, and global partners to discuss how cooperation through the COVID-19 response can build the necessary foundation for equitable and affordable health systems for all.

Featuring

• H.E. Amira El Fadil, Commissioner of Social Affairs, African Union
• H.E. Dr. Jakaya M. Kikwete, former President, United Republic of Tanzania
• Dr. Matshidiso Rebecca Moeti Regional Director, Africa, World Health ...

Community engagement for successful COVID-19 pandemic response: 10 lessons from Ebola outbreak responses in Africa

During public health emergencies, such as the current COVID-19 Public Health Emergency of International Concern, communities are often poorly involved in the planning and implementation of interventions, yet their commitment is fundamental to control outbreaks. Given the experience of responding to Ebola epidemics in Africa, it is imperative that communities must be accountable to the response to COVID-19. Health actors and authorities must co-construct solutions to address COVID-19 with community leaders and communities. 

Approaches to integrating palliative care into African health systems: a qualitative systematic review

Africa is characterized by a high burden of disease and health system deficits, with an overwhelming and increasing demand for palliative care (PC). Yet only one African country is currently considered to have advanced integration of palliative care into medical services and generalized PC is said to be available in only a handful of others. The integration of PC into all levels of a health system has been called for to increase access to PC and to strengthen health systems. Contextually appropriate evidence to guide integration is vital yet limited. This qualitative systematic review analyses interventions to integrate PC into African health systems to provide insight into the ‘how’ of PC integration. Forty articles were identified, describing 51 different interventions. This study found that a variety of integration models are being applied, with limited best practices being evaluated and repeated in other contexts. Interventions typically focused on integrating specialized PC ...

How well are non-communicable disease services being integrated into primary health care in Africa: A review of progress against World Health Organization’s African regional targets

In Africa, mortality due to NCDs is projected to overtake the combined mortality from communicable, maternal, neonatal, and nutritional diseases by 2030. To address this growing NCD burden, PHC systems will require substantial re-orientation. In this tudy published, researchers reviewed progress of African countries towards integrating essential NCD services into PHC. The study found that no country met all the recommended indicators to integrate NCD services into PHC, and seven countries met none of the indicators.

Healthcare team coordination at the Mali Hospital face the psychological difficulties of COVID+ patients

The COVID-19 pandemic crisis has accentuated the problems that fragmented health care systems face to adapt their actions to respond with coordinated services. Public hospitals were brought to the forefront early on in the fight against the pandemic, even though the neoliberal reforms of the last thirty years have largely contributed to undermining their capacity to cope with it. Other factors are challenging the organization of health systems to meet the priority needs of populations, such as the prevalence of hospital-centrism, the requirement that users pay for care when they are sick and visit health services, and the construction of new hospitals in Africa.

Mali Hospital (HDM) received its first patients on March 29, 2020, five days after the first case was identified in the country. The HDM is one of the newest hospitals in the country. Built with the support of Chinese cooperation, it was inaugurated in September 2010 ...

Patient perspectives on integrated healthcare for HIV, hypertension and type 2 diabetes: a scoping review

ntiretroviral therapy has reduced mortality and led to longer life expectancy in people living with HIV. These patients are now at an increased risk of non-communicable diseases (NCDs). Integration of care for HIV and NCDs has become a focus of research and policy. In this article, we aim to review patient perspectives on integration of healthcare for HIV, type 2 diabetes and hypertension. Patient perspectives and experiences on integrated care for HIV, diabetes and hypertension were mostly positive. Integrated services can save resources and allow for a more personalised approach to healthcare. 

Building primary health care teams for universal healthcoverage in Africa

The Alma Ata Declaration on Primary Health Care (PHC) in 1978 defined PHC profoundly. Comprehensiveness and continuity of care, as well as coordination of referrals, were key attributes of integrated PHC. Unfortunately, African governments function with bureaucratic health systems, where top-down implementation policies, especially selective PHC vertical programmes driven by international agencies, create rigid, large, impersonalised units of PHC. Global agencies and country leaders must be challenged on this: what are they doing practically to build PHC teams for UHC in Africa?

Training course in person-centred care is launched by GPCC researchers in the DR Congo

A training course in person-centred care has been carried out in the Democratic Republic of the Congo by researchers at The University of Gothenburg Center for Person-centred Care (GPCC) in Sweden. The course participants had various professions such as midwives, nurses and physicians. The researchers can report on a very positive reception and great commitment, with the potential to have a great future impact.