Assessing the scalability of health system interventions in Africa: protocol for a Delphi study.

Background: There is widespread enthusiasm for scaling interventions to strengthen health systems. However, little is known about the scalability of such interventions in Africa. In this study, we seek to assess the scalability of interventions for improving the functionality of health systems in Africa, as a key to large-scale implementation strategy of interventions with potential for impact.

State of the health workforce in the WHO African Region: decade review of progress and opportunities for policy reforms and investments.

Introduction: An adequate health workforce is one of the cornerstones of a healthy nation. Over the last two decades, Africa has gained momentum in mitigating critical health workforce gaps, but urgent actions are still needed to accelerate progress towards universal health coverage and ensuring health security. This analysis provides an overview of the health workforce in the WHO African Region for the last decade.

Mapping inequalities in health service coverage in Africa: a scoping review.

Objective: In this scoping review, we aim to consolidate the evidence on inequalities in service coverage in Africa using a comprehensive set of stratifiers. These stratifiers include place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status and social capital. Our approach provides a more holistic understanding of the different dimensions of inequality in the context of universal health coverage (UHC).

Projected health workforce requirements and shortage for addressing the disease burden in the WHO Africa Region, 2022-2030: a needs-based modelling study.

Introduction: An adequate health workforce (HWF) is essential to achieving the targets of the Sustainable Development Goals (SDG), including universal health coverage. However, weak HWF planning and constrained fiscal space for health, among other factors in the WHO Africa Region, has consistently resulted in underinvestment in HWF development, shortages of the HWF at the frontlines of service delivery and unemployment of qualified and trained health workers. This is further compounded by the ever-evolving disease burden and reduced access to essential health services along the continuum of health promotion, disease prevention, diagnostics, curative care, rehabilitation and palliative care.

Financing health system elements in Africa: A scoping review.

Countries that are reforming their health systems to progress towards Universal Health Coverage (UHC) need to consider total resource requirements over the long term to plan for the implementation and sustainable financing of UHC. However, there is a lack of detailed conceptualization as to how the current health financing mechanisms interplay across health system elements. Thus, we aimed to generate evidence on how to utilize resources from different sources of funds in Africa.

Mapping health service coverage inequalities in Africa: a scoping review protocol.

Introduction: Addressing inequities in health service coverage is a global priority, especially with the resurgence of interest in universal health coverage. However, in Africa, which has the lowest health service coverage index, there is limited information on the progress of countries in addressing inequalities related to health services. Thus, we seek to map the evidence on inequalities in health service coverage in Africa.

Making districts functional for universal health coverage attainment: lessons from Ghana.

Ensuring the sub national level in the health system can function effectively is central to attainment of health results in countries. However, the current health agenda has not prioritized how districts can deploy their existing resources effectively, to maximize the efficiency equity and effectiveness in their use. Ghana initiated a self-assessment process to understand the functionality of districts to deliver on health results.

Investments for effective functionality of health systems towards Universal Health Coverage in Africa: A scoping review.

The health challenges in Africa underscore the importance of effectively investing in health systems. Unfortunately, there is no information on systems investments adequate for an effective functional health system. We aimed to address this by conducting a scoping review of existing evidence following the Joanna Briggs Institute Manual for Evidence Synthesis and preregistered with the Open Science Framework (https://osf.

Assessing capacities and resilience of health services during the COVID-19 pandemic: Lessons learned from use of rapid key informant surveys.

This Article Is Part Of The Research Topic: 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict.'

Problem: Many countries lacked rapid and nimble data systems to track health service capacities to respond to COVID-19. They struggled to assess and monitor rapidly evolving service disruptions, health workforce capacities, health products availability, community needs and perspectives, and mitigation responses to maintain essential health services.

Trend Analysis of Maternal Mortality in Kenya: Post-Devolution Empirical Results.

Introduction: Kenya has taken significant steps to improve Reproductive Maternal Neonatal Child Adolescent Health (RMNCAH) services, with a vision to prevent preventable deaths of women and newborns. This study seeks to fill a crucial gap in understanding the dynamics of maternal mortality in Kenya, post-devolution.

Materials And Methods: The study spans all the 47 counties of the Republic of Kenya, using county as the unit of analysis.

eHealth or e-Chaos: The use of Digital Health Interventions for Health Systems Strengthening in sub-Saharan Africa over the last 10 years: A scoping review.

Background: Digital health solutions are a potent and complementary intervention in health system strengthening to accelerate universal access to health services. Implementing scalable, sustainable, and integrated digital solutions in a coordinated manner is necessary to experience the benefits of digital interventions in health systems. We sought to establish the breadth and scope of available digital health interventions (DHIs) and their functions in sub-Saharan Africa.

Sub optimal HIV status ascertainment at antenatal clinics and the impact on HIV prevalence estimates: A cross sectional study.

Background: While many countries including Kenya transitioned from sentinel surveillance to the use of routine antenatal care (ANC) data to estimate the burden of HIV, countries in Sub Saharan Africa reported several challenges of this transition, including low uptake of HIV testing and sub national / site-level differences in HIV prevalence estimates. In Kenya voluntary HIV testing is offered to all 1st ANC clients. However, some women may decline testing.

Factors associated with hospital length of stay in patients admitted with suspected malaria in Kenya: secondary analysis of a cross-sectional survey.

Objectives: To investigate factors associated with hospital length of stay (LOS) in patients admitted with suspected malaria using a competing risk approach.

Setting: County government referrals and major faith-based hospitals in Kenya in 2018.

Design: Secondary analysis of a cross-sectional survey data.

COVID-19 in the 47 countries of the WHO African region: a modelling analysis of past trends and future patterns.

Background: COVID-19 has affected the African region in many ways. We aimed to generate robust information on the transmission dynamics of COVID-19 in this region since the beginning of the pandemic and throughout 2022.

Methods: For each of the 47 countries of the WHO African region, we consolidated COVID-19 data from reported infections and deaths (from WHO statistics); published literature on socioecological, biophysical, and public health interventions; and immunity status and variants of concern, to build a dynamic and comprehensive picture of COVID-19 burden.

Use of Digital Health Interventions in Sub-Saharan Africa for Health Systems Strengthening Over the Last 10 Years: A Scoping Review Protocol.

Background: Digital Health Interventions (DHIs) refers to the utilization of digital and mobile technology to support the health system in service delivery. Over the recent years, advanced computing, genomics, and artificial intelligence are considered part of digital health. In the context of the World Health Organization (WHO) global strategy 2020-2025, digital health is defined as "the field of knowledge and practice associated with the development and use of digital technologies to improve health.

Cross country lessons sharing on practices, challenges and innovation in primary health care revitalization and universal health coverage implementation among 18 countries in the WHO African Region.

The fifth health sector directors´ policy and planning meeting for the World Health Organization (WHO) regional office for Africa convened to focus on building health system resilience during the COVID-19 pandemic to ensure continuity of essential health services, primary health care (PHC) revitalization, and health system strengthening towards achieving universal health coverage (UHC). In this paper, we present short summaries and experiences shared by 18 countries, for which their practices and outcomes have been documented in this manuscript. These actions are aligned with six key themes: (i) defining and making more essential health services available, (ii) increasing service coverage targeting hard to reach populations, (iii) financial risk protection, (iv) improving user satisfaction with services, (v) improving health security, and (vi) improving coverage with health-related sector services.

Transitioning to Digital Systems: The Role of World Health Organization's Digital Adaptation Kits in Operationalizing Recommendations and Interoperability Standards.

Introduction: The transition from paper to digital systems requires quality assurance of the underlying content and application of data standards for interoperability. The World Health Organization (WHO) developed digital adaptation kits (DAKs) as an operational and software-neutral mechanism to translate WHO guidelines into a standardized format that can be more easily incorporated into digital systems.

Methods: WHO convened health program area and digital leads, reviewed existing approaches for requirements gathering, mapped to established standards, and incorporated research findings to define DAK components.

On the resilience of health systems: A methodological exploration across countries in the WHO African Region.

The need for resilient health systems is recognized as important for the attainment of health outcomes, given the current shocks to health services. Resilience has been defined as the capacity to "prepare and effectively respond to crises; maintain core functions; and, informed by lessons learnt, reorganize if conditions require it". There is however a recognized dichotomy between its conceptualization in literature, and its application in practice.

Cross-sectional study to predict subnational levels of health workers' knowledge about severe malaria treatment in Kenya.

Objectives: This study applied a Bayesian hierarchical ecological spatial model beyond predictor analysis to test for the best fitting spatial effects model to predict subnational levels of health workers' knowledge of severe malaria treatment policy, artesunate dosing, and preparation.

Setting: County referral government and major faith-based hospitals across 47 counties in Kenya in 2019.

Design And Participants: A secondary analysis of cross-sectional survey data from 345 health workers across 89 hospitals with inpatient departments who were randomly selected and interviewed.

Towards universal health coverage in the WHO African Region: assessing health system functionality, incorporating lessons from COVID-19.

The move towards universal health coverage is premised on having well-functioning health systems, which can assure provision of the essential health and related services people need. Efforts to define ways to assess functionality of health systems have however varied, with many not translating into concrete policy action and influence on system development. We present an approach to provide countries with information on the functionality of their systems in a manner that will facilitate movement towards universal health coverage.

Building health system resilience in the context of primary health care revitalization for attainment of UHC: proceedings from the Fifth Health Sector Directors' Policy and Planning Meeting for the WHO African Region.

Background: The recent 2018 Declaration of Astana recognized primary health care (PHC) as a means to achieve universal health coverage (UHC) and the health-related Sustainable Development Goals (SDGs). Following this declaration, country progress on operationalization of the PHC agenda and attainment of UHC has been stalled by the new challenges posed by the COVID-19 pandemic. The pandemic has also disrupted the continuity of essential health service provision and tested the resilience of the region's health systems.

Predictors of health workers' knowledge about artesunate-based severe malaria treatment recommendations in government and faith-based hospitals in Kenya.

Background: Health workers' knowledge deficiencies about artesunate-based severe malaria treatment recommendations have been reported. However, predictors of the treatment knowledge have not been examined. In this paper, predictors of artesunate-based treatment knowledge among inpatient health workers in two hospital sectors in Kenya are reported.

The potential effects of widespread community transmission of SARS-CoV-2 infection in the World Health Organization African Region: a predictive model.

The spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been unprecedented in its speed and effects. Interruption of its transmission to prevent widespread community transmission is critical because its effects go beyond the number of COVID-19 cases and deaths and affect the health system capacity to provide other essential services. Highlighting the implications of such a situation, the predictions presented here are derived using a Markov chain model, with the transition states and country specific probabilities derived based on currently available knowledge.