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  1. Article ; Online: The effect of performance-based financing interventions on out-of-pocket expenses intended to improve access to and utilization of maternal health services in sub-Saharan Africa

    Miriam Nkangu / Julian Little / Olumuyiwa Omonaiye / Sanni Yaya

    Systematic Reviews, Vol 11, Iss 1, Pp 1-

    protocol for a systematic review and meta-analysis

    2022  Volume 10

    Abstract: Abstract Background Out-of-pocket expenses have been reported as a major barrier to accessing antenatal care and skilled birth delivery in most of sub-Saharan Africa. Performance-based financing (PBF) is one of several strategies introduced in lower- and ...

    Abstract Abstract Background Out-of-pocket expenses have been reported as a major barrier to accessing antenatal care and skilled birth delivery in most of sub-Saharan Africa. Performance-based financing (PBF) is one of several strategies introduced in lower- and middle-income countries to strengthen a weak health system. This review aims to synthesize evidence on the effectiveness of PBF interventions implemented with the objective of reducing out-of-pocket expenses and improving access to and utilization of ANC and skilled birth delivery and family planning in sub-Saharan Africa. It will consider evidence across health sectors and identify gaps in the evidence. Methods and analysis This protocol is reported according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guideline. The systematic review will apply a three-step strategy to search five databases (CINAHL, PubMed, Ovid Medline, EMBASE, Cochrane.) and grey literature with the help of a librarian. Two independent reviewers will conduct screening to determine eligibility and critical appraisal of selected studies using the risk of bias criteria developed by the Cochrane EPOC Group and the New Castle Ottawa Scale for observational studies. The certainty of evidence for the outcomes will be assessed using “Grades of Recommendation, Assessment, Development, and Evaluation” (GRADE) approach. This review will consider experimental and quasi-experimental study designs and observational studies. Studies published in English and French language(s) will be included. Studies published since the introduction of PBF in sub-Saharan Africa will be included. Data will be collected on each item that contributes to out-of-pocket expenses. This review will adopt the Multiple Dimensions of Access Framework to organize the findings. Discussion This systematic review will support evidence-informed data for the performance-based financing community and government by identifying, describing, and assessing the impact of performance-based financing ...
    Keywords Performance-based financing ; Out-of-pocket expenses ; Access ; Health sector ; Systematic review ; Maternal health services ; Medicine ; R
    Subject code 306
    Language English
    Publishing date 2022-06-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Examining the Implementation of the Performance-Based Financing Equity Strategy in Improving Access and Utilization of Maternal Health Services in Cameroon

    Miriam Nkangu / Julian Little / Constantine Asahngwa / Raywat Deonandan / Roland Pongou / Orvill Adams / Sanni Yaya

    International Journal of Environmental Research and Public Health, Vol 19, Iss 14132, p

    A Qualitative Study

    2022  Volume 14132

    Abstract: Performance-based financing (PBF)—a supply-side strategy that incentivizes health providers based on predefined quality and quantity criteria—introduced an innovative approach to reaching the poor by means of using PBF equity instruments. These PBF ... ...

    Abstract Performance-based financing (PBF)—a supply-side strategy that incentivizes health providers based on predefined quality and quantity criteria—introduced an innovative approach to reaching the poor by means of using PBF equity instruments. These PBF equity instruments include paying providers more to reach out to poor women, selecting services used by the poor, subsidizing user fees to reduce out-of-pocket expenses, and adding complementary demand-side intervention. Before the implementation of the PBF equity instrument in Cameroon, there were few initiatives/schemes to enable the poor to access maternal health services. Moreover, there is a significant research gap on how the equity elements are defined and implemented across contexts. This study aims to understand (i) how health facilities define and classify the poor and vulnerable in the context of PBF, (ii) how the equity elements are implemented at the community and facility levels, and (iii) the potential impact on access to and the use of maternal health services at the facility level and challenges in the implementation process. We used key informant interviews and focus group discussions (FGDs) based on a grounded theory approach to gain an understanding of the social processes and experiences. Data were collected from three districts in the Southwest region of Cameroon from April 2021 to August 2021. Data were transcribed and analyzed using MaxQDA. The thematic analysis approach/technique was used to analyze data. Key informant interviews and focus groups were conducted with 79 participants, including 28 health professionals and service administrators, 27 pregnant women, and 24 community health workers in three districts. Health facilities employed various subjective approaches to assess and define poor and vulnerable (PAV) persons. Home visits were reported to have an impact in reaching the poor and vulnerable to improve access to maternal services. Meanwhile, a delay in the payment of PBF incentives was reported to be the main challenge that had a ...
    Keywords performance-based financing ; equity ; maternal health ; grounded theory ; poor and vulnerable ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2022-10-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Scoping review protocol to understand the conceptualisation, implementation and practices of health promotion within the context of primary healthcare in Africa

    Miriam Nkangu / Pamela Obegu / Constantine Asahngwa / Veronica Shiroya / Ronald Gobina / Fleur Pembe Agbaw-Ebai / Mark Keboa / Denis Foretia

    BMJ Open, Vol 11, Iss

    2021  Volume 12

    Keywords Medicine ; R
    Language English
    Publishing date 2021-12-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Government policy interventions to reduce human antimicrobial use

    Susan Rogers Van Katwyk / Jeremy M Grimshaw / Miriam Nkangu / Ranjana Nagi / Marc Mendelson / Monica Taljaard / Steven J Hoffman

    PLoS Medicine, Vol 16, Iss 6, p e

    A systematic review and evidence map.

    2019  Volume 1002819

    Abstract: Background Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to ... ...

    Abstract Background Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidence map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans. Methods and findings Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review. Conclusions To our ...
    Keywords Medicine ; R
    Subject code 360
    Language English
    Publishing date 2019-06-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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  5. Article ; Online: Guidance relevant to the reporting of health equity in observational research

    Elizabeth Loder / Taryn Young / Peter Tugwell / Matire Harwood / Tamara Kredo / Xiaoqin Wang / Lawrence Mbuagbaw / Charles Shey Wiysonge / Catherine Chamberlain / Jacqueline Ramke / Elie A Akl / Vivian A Welch / Julian Little / Larissa Shamseer / Zulfiqar Bhutta / Daeria O Lawson / Janet Elizabeth Jull / Tamara Rader / Michelle Kennedy /
    Stuart Nicholls / Billie-Jo Hardy / Elizabeth Ghogomu / Miriam Nkangu / Michael Johnson J Mahande / Omar Dewidar / Anita Rizvi / Olivia Magwood / Holly Ellingwood / Regina Greer-Smith / Patrick M Okwen / Janice Tufte

    BMJ Open, Vol 12, Iss

    a scoping review protocol

    2022  Volume 5

    Keywords Medicine ; R
    Language English
    Publishing date 2022-05-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Improving Social Justice in COVID-19 Health Research

    Alba Antequera / Daeria O. Lawson / Stephen G. Noorduyn / Omar Dewidar / Marc Avey / Zulfiqar A. Bhutta / Catherine Chamberlain / Holly Ellingwood / Damian Francis / Sarah Funnell / Elizabeth Ghogomu / Regina Greer-Smith / Tanya Horsley / Clara Juando-Prats / Janet Jull / Elizabeth Kristjansson / Julian Little / Stuart G. Nicholls / Miriam Nkangu /
    Mark Petticrew / Gabriel Rada / Anita Rizvi / Larissa Shamseer / Melissa K. Sharp / Janice Tufte / Peter Tugwell / Francisca Verdugo-Paiva / Harry Wang / Xiaoqin Wang / Lawrence Mbuagbaw / Vivian Welch

    International Journal of Environmental Research and Public Health, Vol 18, Iss 9357, p

    Interim Guidelines for Reporting Health Equity in Observational Studies

    2021  Volume 9357

    Abstract: The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observational studies are a valuable source of evidence for real-world effects and impacts of implementing COVID-19 policies on the redistribution of inequities. We ...

    Abstract The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observational studies are a valuable source of evidence for real-world effects and impacts of implementing COVID-19 policies on the redistribution of inequities. We assembled a diverse global multi-disciplinary team to develop interim guidance for improving transparency in reporting health equity in COVID-19 observational studies. We identified 14 areas in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist that need additional detail to encourage transparent reporting of health equity. We searched for examples of COVID-19 observational studies that analysed and reported health equity analysis across one or more social determinants of health. We engaged with Indigenous stakeholders and others groups experiencing health inequities to co-produce this guidance and to bring an intersectional lens. Taking health equity and social determinants of health into account contributes to the clinical and epidemiological understanding of the disease, identifying specific needs and supporting decision-making processes. Stakeholders are encouraged to consider using this guidance on observational research to help provide evidence to close the inequitable gaps in health outcomes.
    Keywords health inequities ; observational studies ; COVID-19 ; guidelines ; reporting ; public health ; Medicine ; R
    Language English
    Publishing date 2021-09-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

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