Contribution of the Japan International Cooperation Agency health-related projects to health system strengthening
Tóm tắt
The Japan International Cooperation Agency (JICA) has focused its attention on appraising health development assistance projects and redirecting efforts towards health system strengthening. This study aimed to describe the type of project and targets of interest, and assess the contribution of JICA health-related projects to strengthening health systems worldwide. We collected a web-based Project Design Matrix (PDM) of 105 JICA projects implemented between January 2005 and December 2009. We developed an analytical matrix based on the World Health Organization (WHO) health system framework to examine the PDM data and thereby assess the projects’ contributions to health system strengthening. The majority of JICA projects had prioritized workforce development, and improvements in governance and service delivery. Conversely, there was little assistance for finance or medical product development. The vast majority (87.6%) of JICA projects addressed public health issues, for example programs to improve maternal and child health, and the prevention and treatment of infectious diseases such as AIDS, tuberculosis and malaria. Nearly 90% of JICA technical healthcare assistance directly focused on improving governance as the most critical means of accomplishing its goals. Our study confirmed that JICA projects met the goals of bilateral cooperation by developing workforce capacity and governance. Nevertheless, our findings suggest that JICA assistance could be used to support financial aspects of healthcare systems, which is an area of increasing concern. We also showed that the analytical matrix methodology is an effective means of examining the component of health system strengthening to which the activity and output of a project contributes. This may help policy makers and practitioners focus future projects on priority areas.
Tài liệu tham khảo
World Health Organization: World Health Report 2000 -Health systems: Improving performance. 2000, Geneva, Switzerland: WHO press, 5-7.
World Health Organization: World Health Report 2003: Chapter 7, health system –principled integrated care. 2003, Geneva, Switzerland: WHO press, 105-131.
Frenk J, Gonzalez-Pier E, Gomez-Dantes O, Lezana MA, Knaul FM: Comprehensive reform to improve health system performance in Mexico. Lancet. 2006, 368: 1524-1534. 10.1016/S0140-6736(06)69564-0.
World Bank: World development report 1993; Investing in health-World development indicators. Book World development report 1993; Investing in health-World development indicators. 1993, New York: Oxford University Press
Travis P, Bennett S, Haines A, Pang T, Bhutta Z, Hyder AA, Pielemeier NR, Mills A, Evans T: Overcoming health-systems constraints to achieve the Millennium Development Goals. Lancet. 2004, 364: 900-906. 10.1016/S0140-6736(04)16987-0.
World Health Organization Executive Board: Health system strengthening: current trends and challenges, report by the Secretariat. EB128/37. 2010, Switzerland: WHO Secretariat in Geneva
Cohn J, Russell A, Baker B, Kayongo A, Wanjiku E, Davis P: Using global health initiatives to strengthen health systems: a civil society perspective. Global public health. 2011, 6: 687-702. 10.1080/17441692.2010.521165.
Galichet B, Goeman L, Hill PS, Essengue MS, Hammami N, Porignon D, Kadama P, Van Lerberghe W: Linking programmes and systems: lessons from the GAVI Health Systems Strengthening window. Trop Med Int Health. 2010, 15: 208-215. 10.1111/j.1365-3156.2009.02441.x.
Arah OA, Westert GP: Correlates of health and healthcare performance: applying the Canadian Health Indicators Framework at the provincial-territorial level. BMC health services research. 2005, 5: 76-10.1186/1472-6963-5-76.
Bossert TJ, Beauvais JC: Decentralization of health systems in Ghana, Zambia, Uganda and the Philippines: a comparative analysis of decision space. Health Policy Plan. 2002, 17: 14-31. 10.1093/heapol/17.1.14.
ten Asbroek AH, Arah OA, Geelhoed J, Custers T, Delnoij DM, Klazinga NS: Developing a national performance indicator framework for the Dutch health system. Int J Qual Health Care. 2004, 16 (Suppl 1): i65-71.
WHO: Everybody business: Strengtheninh health systems to improve health outcomes: WHO's framework for action. 2007, 1-5.
Adam T, Ahmad S, Bigdeli M, Ghaffar A, Rottingen JA: Trends in health policy and systems research over the past decade: still too little capacity in low-income countries. PLoS One. 2011, 6: 27263-10.1371/journal.pone.0027263.
Evans T, Nishtar S, Atun R, Etienne C: Scaling up research and learning for health systems: time to act. Lancet. 2008, 372: 1529-1531. 10.1016/S0140-6736(08)61634-7.
Mills A, Gilson L, Hanson K, Palmer N, Lagarde M: What do we mean by rigorous health-systems research?. Lancet. 2008, 372: 1527-1529. 10.1016/S0140-6736(08)61633-5.
Adam T, Hsu J, de Savigny D, Lavis JN, Rottingen JA, Bennett S: Evaluating health systems strengthening interventions in low-income and middle-income countries: are we asking the right questions?. Health Policy Plan. 2012, 27 (Suppl 4): iv9-19. 10.1093/heapol/czs086.
EuroAid Cooperation Office: Aid delivery methods: Project Cycle Management Guildlines. European Commission. 2004, Brussels: European Commission,http://ec.europa.eu/europeaid/multimedia/publications/documents/tools/europeaid_adm_pcm_guidelines_2004_en.pdf,
Foundation for Advanced Studies on International Development: Project Cycle Management, revised version. 1994
Doey L, Kurta J: Correspondence analysis applied to psychological reserach. Tutorials in Quantitative Methods dor Psychology. 2011, 7: 5-14.
Organization WH: Towards better leadership and management in health: Report on an international consultation on strengthening leadership and management in low-income countries. 2007, Making health system work: Working Papaer, 10-
Hongoro C, McPake B: How to bridge the gap in human resources for health. Lancet. 2004, 364: 1451-1456. 10.1016/S0140-6736(04)17229-2.
Kojima S, Looareesuwan S, Singhasivanon P, Takeuchi T: The Asian center of international parasite control (ACIPAC): five years of achievement. I. Introduction. Southeast Asian J Trop Med Public Health. 2005, 36 (Suppl 3): 1-12.
Yamagata Y, Nakagawa J: Control of Chagas disease. Adv Parasitol. 2006, 61: 129-165.
Wakai K, Matsuo K: The JICA training course, community-based cancer prevention for the Asian and Pan-Pacific countries, fiscal year 2006 (epidemiological approach). Asian Pac J Cancer Prev. 2007, 8: 150-154.
Organization WH: Economics and financial management: What do district managers need to know?. 2006, Making health system work: Working Papaer, 6-
Chernichovsky D, Martinez G, Aguilera N: Reforming "developing" health systems: Tanzania, Mexico, and the United States. Adv Health Econ Health Serv Res. 2009, 21: 313-338.
Ingram RC, Bernet PM, Costich JF: Public health services and systems research: current state of finance research. J Public Health Manag Pract. 2012, 18: 515-519. 10.1097/PHH.0b013e31825fbb40.
Stuckler D, Basu S, McKee M: International Monetary Fund and aid displacement. Int J Health Serv. 2011, 41: 67-76. 10.2190/HS.41.1.e.
McCoy D, Chand S, Sridhar D: Global health funding: how much, where it comes from and where it goes. Health Policy Plan. 2009, 24: 407-417. 10.1093/heapol/czp026.
Samb B, Evans T, Dybul M, Atun R, Moatti JP, Nishtar S, Wright A, Celletti F, Hsu J, Kim JY: An assessment of interactions between global health initiatives and country health systems. Lancet. 2009, 373: 2137-2169.
Sheikh M, Cometto G, Duvivier R: Universal health coverage and the post-2015 agenda. Lancet. 2013, 381: 725-726.
The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-698X/13/39/prepub