Swaziland Health Research - Research Topics #5

Research Agenda

Research Areas: Health System Strengthening

A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities. A health system is therefore more than the pyramid of publicly owned facilities that deliver personal health services. It includes, for example, a mother caring for a sick child at home; private providers; behaviour change programmes; vector-control campaigns; health insurance organizations; occupational health and safety legislation. It includes inter-sectorial action by health staff, for example, encouraging the ministry of education to promote female education, a well-known determinant of better health.

1. Service Delivery
Assessment of situation and determinants:
  • Assess health system performance of its goals of health improvement (level and equity), responsiveness to client non-medical expectations, social and financial risk protection, and efficiency improvement.
  • Assess health facilities readiness in general and specific services.
  • Assess efficiency/effectiveness of referral system.

Research to Improve Existing Interventions:
  • Develop strategies to improve coverage, quality and safety of health services.
  • Developstrategies to enhance public-private partnerships for service provision.

Research to Improve Effectiveness and Cost-Effectiveness:
  • Determine feasibility and cost-effectiveness analysis of telemedicine and e-health services.
  • Estimate costing of health services at all levels for use in planning.

Developing new capacities (tools and products):
  • Develop models forhealth systems approaches in providing integrated services.


2. Health Workforce
Assessment of situation and determinants:
  • Assess quantity and quality of health workers produced per year.
  • Quantify the number and distribution of health workers.

Research to Improve Existing Interventions:
  • Assess strategies to improve recruitment, deployment, retention and productivity of quality health workers.

Research to Improve Effectiveness and Cost-Effectiveness:
  • Determine effectiveness of task shifting
  • Evaluate impact and relevance of pre-service and in-service training to the current health needs.


3. Health Information Systems
Assessment of situation and determinants:
  • Review national health information system, including availability and accessibility of HMIS, research and community management information system (CMIS) products to stakeholders.
  • Identify data and management information systems that exist at community level and how they interface with HMIS.
  • Identify barriers/ enablers affecting generation and use of information for decision-making.

Research to Improve Existing Interventions:
  • Develop strategies to optimize the relevance and use of health information in decision making.
  • Develop strategies to ensure coordinated system for capturing data generated in the community systems.

Research to Improve Effectiveness and Cost-Effectiveness:
  • Conduct feasibility and cost-effectiveness analysis of the use of mobile technologies in health information management, including disease surveillance.


4. Medical Products and Technologies
Assessment of situation and determinants:
  • Assess needs and availability of essential medicines and pricing.
  • Assess health technology and utilization.

Research to Improve Existing Interventions:
  • Determine strategies to improve rational use of medical, laboratory and pharmaceutical products.
  • Develop strategies to improve pharmacovigilance.

Research to Improve Effectiveness and Cost-Effectiveness:
  • Conduct cost –effectiveness analysis of the existing procurement system.


5. Health financing
Assessment of situation and determinants:
  • Conduct national health accounts to track the flow of funds from sources to final uses.
  • Assess overall political acceptability,systemic/institutional and organizational capacity to launch social health insurance scheme.
  • Assess willingness of formal private-sector employees and civil servants to accept the solidarity principle and to contribute according to capacity to pay.
  • Analyse health care utilization and financial risk protection.

Research to Improve Existing Interventions:
  • Develop strategies to protect health care users from catastrophic expenditures, e.g. exemptions from user fees.
  • Determine strategies to improve efficiency of revenue collection, fund pooling and purchasing of health system inputs and services.

Research to Improve Effectiveness and Cost-Effectiveness:
  • Develop methods for cost-benefit and cost-effective analysis of relevant health care interventions.

  • Development of new capacities (tools and products):
  • Design of national social health insurance scheme.


6. Leadership and Governance
Assessment of the situation and determinants:
  • Analyse effectiveness and efficiency of the existing regulatory frameworks and leadership and governance structures in executing their functions to address the health needs of the population.
  • Analyseconstraining / facilitating factors in existing organizational structure to effectively deliver on the national health policy and strategic plan.

Research to Improve Existing Interventions:
  • Develop strategies to increase compliance with existing interventions.
  • Develop strategies for strengthening coordination of interventions at facility and community level.


7. Community System Strengthening
Assessment of burden and determinants:
  • Assess factors influencing access and utilization of health services at community level.

Research to improve policy and systems:
  • Provide evidence for health policy and social welfare of communities.
  • Develop strategies to strengthen coordination of NGOs and community based organizations (CBOs) supporting specific communities.

Research to Improve Existing Interventions:
  • Develop strategies to efficiently interface traditional and modern medicine.
  • Develop strategies to improve community health services, for example, utilizing retired health workers.
  • Develop strategies to increase community demand for quality health services.
  • Identify strategies for effective involvement of men in reproductive, maternal, neonatal, child and adolescent health.
  • Investigate optimal implementation and evaluation of community based primary prevention models for NCDs with particular attention to the effects of rural–urban migration and changing food preferences, physical activity patterns and transportation policy.

Research to Improve Effectiveness and Cost-Effectiveness:
  • Assess the impact of relevant community interventions.
  • Design and test the effectiveness of different models of community health workers supervision to implement community based interventions.

Contacts

Physical Address: Christian University Building, Office #, Mbabane, Swaziland

Postal Address: P.O Box 5 Mbabane, Swaziland

Phone: 2404 4905

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