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FIXING HEALTH SYSTEMS
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ID: 64437Added: 2004-08-27 8:37Modified: 2008-09-04 14:41Refreshed: 2008-11-19 02:21 
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Book(s) 12 of 222
in_focus: FIXING HEALTH SYSTEMS (2nd edition)Don de Savigny, Harun Kasale, Conrad Mbuya, and Graham Reid IDRC 2008 ISBN 978-1-55250-409-3 e-ISBN 978-1-55250-411-6 150 pp.   
In 1993, the World Development Report suggested that directing health care budgets more proportionally toward the local “burden of disease” could significantly lower rates of death and disease. As the original edition of Fixing Health Systems revealed, the TEHIP program provided powerful evidence in support of that hypothesis. In TEHIP’s two Tanzanian test districts, for example, modest funding increases and sweeping organizational changes contributed to decreases in child mortality of more than 40%. Now, this second edition moves beyond the hopeful story of how TEHIP’s interlocking web of systemic reforms improved the health outlook in Tanzania. With a new epilogue and preface, this updated volume also explores how the TEHIP example has helped create a paradigm shift in Africa and within the global health community. With its accompanying CD, which presents the associated website (www.idrc.ca/in_focus_tehip), this book remains an indispensable resource for decision-makers, researchers, policy advisors, and activists in health and international development around the world. THE AUTHORS Don de Savigny, formerly TEHIP Research Manager for IDRC, is now Head of the Health Systems Interventions Research Unit at the Swiss Tropical Institute. Harun Kasale, formerly TEHIP Project Coordinator, and Conrad Mbuya, formerly TEHIP Research Coordinator, are, respectively, Lead Consultant and Consultant for the National Expansion of TEHIP Tools and the Strengthening of Zonal Health Resource Centres, Ministry of Health and Social Work, Tanzania. Graham Reid, formerly TEHIP Project Manager, is now Senior Program Specialist at IDRC’s office in Nairobi.
Book(s) 12 of 222
FIXING HEALTH SYSTEMS / Foreword M.J. Mwaffisi 2008 FIXING HEALTH SYSTEMS / Preface to the Second Edition Christina Zarowsky 2008 FIXING HEALTH SYSTEMS / Preface to the First Edition 2008 FIXING HEALTH SYSTEMS / 1. The idea 2008 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 2008 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 2008 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 2008 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 2008 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 / Epilogue: TEHIP Maintains its Momentum 2008 With TEHIP set to fade into history, it became increasingly clear that special efforts were required to ensure that advances made through the “special case” of TEHIP became commonplace features of day-to-day health care delivery over a wider geographic span. Early scaling up Maintaining momentum Enter the "exit strategy" Dissemination Replication Planning for sustainability/institutional strengthening Continued data collection and population health research Fundraising FIXING HEALTH SYSTEMS / Appendix 1. Acknowledgments 2008 FIXING HEALTH SYSTEMS / Appendix 2. Glossary of terms and list of acronyms 2008 FIXING HEALTH SYSTEMS / Appendix 3. Sources and resources 2004 The International Development Research Centre (IDRC) needs your help! Please help us improve our website by completing this three-minute survey. We greatly appreciate your time and value your feedback. Thank you! or |
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