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FIXING HEALTH SYSTEMS
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ID: 64437Added: 2004-08-27 8:37Modified: 2005-08-24 11:19Refreshed: 2006-01-25 06:46 
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Book(s) 30 of 193
In_Focus: FIXING HEALTH SYSTEMSDon de Savigny, Harun Kasale, Conrad Mbuya, and Graham Reid IDRC 2004 ISBN 1-55250-155-8 126 pp.   
Disponible en français The daunting health challenges now confronting Africa, and the rest of the developing world, have been well publicized. Malaria, HIV/AIDS, tuberculosis, malnutrition, anemia: all devastating epidemics whose effects are multiplied by conditions of poverty. In Tanzania, however, recent experience and research are providing cause for optimism. In 1993, the World Development Report suggested that mortality rates could be significantly reduced if resources were directed more in line with local “burden of disease.” The TEHIP program was founded to test this idea. After a decade of research and experience, the verdict is in: the idea is solid, and has produced some remarkable results. Two districts in Tanzania, for example, have seen child mortality rates fall by more than 40%. This book presents the TEHIP story. It is a story of hope, and holds important lessons that can be applied widely throughout the countries of the developing world, and beyond. With its accompanying CD, which presents the associated Web site (www.idrc.ca/tehip), this book will be an indispensable resource for decision-makers, researchers, policy advisors, and activists in health and international development around the world. THE AUTHORS Don de Savigny is Research Manager of the Tanzanian Essential Health Interventions Project (TEHIP), IDRC. Harun Kasale is TEHIP’s Project Coordinator (Ministry of Health, Tanzania). Conrad Mbuya is TEHIP’s Research Coordinator (Ministry of Health, Tanzania). Graham Reid is TEHIP’s Project Manager, IDRC.
Book(s) 30 of 193
FIXING HEALTH SYSTEMS / Foreword 2004 FIXING HEALTH SYSTEMS / Preface 2004 FIXING HEALTH SYSTEMS / 1. The idea 2004 In Africa, health care has been in a state of crisis for several decades. The Tanzania Essential Health Interventions Project (TEHIP) has sought to test a premise that called for health reforms based not just on increased funding but on more strategic investments in health. A history of hope and struggle Bold new initiatives TEHIP's piece of the puzzle Testing a potent idea Complexity anchored by fundamental questions The need for an integrated approach Efficiency leads to equity FIXING HEALTH SYSTEMS / 2. The approach 2004 Two large districts in Tanzania -- already engaged in health reforms centred on devolving management of resources to the local level -- attempt to bring health spending more in line with cost-effective approaches to the local disease burden. Information from Demographic Surveillance Systems makes it possible for planners to determine spending priorities. A series of simple management tools enable those district planners to allot funds to interventions that will have a greater impact on local causes of mortality. Integrating research and development The consortium approach The research begins The Demographic Surveillance System The evolution of the tools FIXING HEALTH SYSTEMS / 3. The results 2004 New means of planning lead district health teams to budget more proportionally to address major contributors to mortality such as malaria and a cluster of childhood illnesses. Effectively addressing those problems, however, requires that a modest funding top-up be applied to increasing capacity within the health system. This allows for better training, more effective deployment of resources such as drugs, better clinical practice, and increased patient satisfaction. The overall result is a dramatic decline in mortality in the two districts. Supplementary funding Capacity building in management and administration The Integrated Management Cascade Rehabilitation of health facilities What the districts did with budget planning tools A new assault on disease Integrated Management of Childhood Illnesses Conclusion FIXING HEALTH SYSTEMS / 4. Extending TEHIP's innovation and impact 2004 The two districts' success in substantially lowering mortality demands that the tools for achieving that success be disseminated more widely, both within Tanzania and internationally. This section of the book documents current efforts to extend the impact of the TEHIP innovations. FIXING HEALTH SYSTEMS / 5. Lessons learned 2004 The primary lesson arising from the TEHIP experience is that investing in health systems is an effective way of improving population health. This chapter presents the critical lessons learned from the TEHIP experience. General principles People Infrastructure Governance Information Conclusion FIXING HEALTH SYSTEMS / Appendix 1. Acknowledgments 2004 FIXING HEALTH SYSTEMS / Appendix 2. Glossary of terms and list of acronyms 2004 FIXING HEALTH SYSTEMS / Appendix 3. Sources and resources 2004 |
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