Promoting progress in child survival across four African countries: the role of strong health governance and leadership in maternal, neonatal and child health
| Autor: | Connie A. Haley, Kasonde Mwinga, Sten H. Vermund, Stephen B. Kennedy, Margaret Maimbolwa, Marie A. Brault, Teshome Desta, Kenneth Ngure, Precious Moyo, Aaron M. Kipp |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Economic growth Child Health Services Millennium Development Goals 03 medical and health sciences 0302 clinical medicine Pregnancy Political science parasitic diseases Humans Maternal Health Services 030212 general & internal medicine 10. No inequality health services Child Africa South of the Sahara Pace 2. Zero hunger Sustainable development Strategic planning Child health 030503 health policy & services Corporate governance Health Policy 1. No poverty Infant Newborn Infant Original Articles 3. Good health Child mortality Leadership governance accountability Child Preschool Accountability Child Mortality Organizational Case Studies Female 0305 other medical science qualitative research Qualitative research |
| Zdroj: | Health Policy and Planning |
| ISSN: | 1460-2237 0268-1080 |
| Popis: | Despite numerous international and national efforts, only 12 countries in the World Health Organization’s African Region met the Millennium Development Goal #4 (MDG#4) to reduce under-five mortality by two-thirds by 2015. Given the variability across sub-Saharan Africa, a four-country study was undertaken to examine barriers and facilitators of child survival prior to 2015. Liberia and Zambia were chosen to represent countries making substantial progress towards MDG#4, while Kenya and Zimbabwe represented countries making less progress. Our individual case studies suggested that strong health governance and leadership (HGL) was a significant driver of the greater success in Liberia and Zambia compared with Kenya and Zimbabwe. To elucidate specific components of national HGL that may have substantially influenced the pace of reductions in child mortality, we conducted a cross-country analysis of national policies and strategies pertaining to maternal, neonatal and child health (MNCH) and qualitative interviews with individuals working in MNCH in each of the four study countries. The three aspects of HGL identified in this study which most consistently contributed to the different progress towards MDG#4 among the four study countries were (1) establishing child survival as a top national priority backed by a comprehensive policy and strategy framework and sufficient human, financial and material resources; (2) bringing together donors, strategic partners, health and non-health stakeholders and beneficiaries to collaborate in strategic planning, decision-making, resource-allocation and coordination of services; and (3) maintaining accountability through a ‘monitor-review-act’ approach to improve MNCH. Although child mortality in sub-Saharan Africa remains high, this comparative study suggests key health leadership and governance factors that can facilitate reduction of child mortality and may prove useful in tackling current Sustainable Development Goals. |
| Databáze: | OpenAIRE |
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