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Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants
BACKGROUND: Despite the increase in Health System Strengthening (HSS) grants, there is no consensus among global health actors about how to maximize the efficiency and sustainability of HSS programs and their resulting gains. To formally analyze and compare the efficiency and sustainability of Gavi’...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Williams & Wilkins
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5916462/ https://www.ncbi.nlm.nih.gov/pubmed/29278610 http://dx.doi.org/10.1097/INF.0000000000001848 |
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author | Mimche, Honoré Squires, Ellen Miangotar, Yodé Mokdad, Ali El Bcheraoui, Charbel |
author_facet | Mimche, Honoré Squires, Ellen Miangotar, Yodé Mokdad, Ali El Bcheraoui, Charbel |
author_sort | Mimche, Honoré |
collection | PubMed |
description | BACKGROUND: Despite the increase in Health System Strengthening (HSS) grants, there is no consensus among global health actors about how to maximize the efficiency and sustainability of HSS programs and their resulting gains. To formally analyze and compare the efficiency and sustainability of Gavi’s HSS grants, we investigated the factors, events and root causes that increased the time and effort needed to implement HSS grants, decreased expected outcomes and threatened the continuity of activities and the sustainability of the results gained through these grants in Cameron and Chad. METHODS: We conducted 2 retrospective independent evaluations of Gavi’s HSS support in Cameroon and Chad using a mixed methodology. We investigated the chain of events and situations that increased the effort and time required to implement the HSS programs, decreased the value of the funds spent and hindered the sustainability of the implemented activities and gains achieved. RESULTS: Root causes affecting the efficiency and sustainability of HSS grants were common to Cameroon and Chad. Weaknesses in health workforce and leadership/governance of the health system in both countries led to interrupting the HSS grants, reprogramming them, almost doubling their implementation period, shifting their focus during implementation toward procurements and service provision, leaving both countries without solid exit plans to maintain the results gained. CONCLUSIONS: To increase the efficiency and sustainability of Gavi’s HSS grants, recipient countries need to consider health workforce and leadership/governance prior, or in parallel to strengthening other building blocks of their health systems. |
format | Online Article Text |
id | pubmed-5916462 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-59164622018-05-02 Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants Mimche, Honoré Squires, Ellen Miangotar, Yodé Mokdad, Ali El Bcheraoui, Charbel Pediatr Infect Dis J Original Studies BACKGROUND: Despite the increase in Health System Strengthening (HSS) grants, there is no consensus among global health actors about how to maximize the efficiency and sustainability of HSS programs and their resulting gains. To formally analyze and compare the efficiency and sustainability of Gavi’s HSS grants, we investigated the factors, events and root causes that increased the time and effort needed to implement HSS grants, decreased expected outcomes and threatened the continuity of activities and the sustainability of the results gained through these grants in Cameron and Chad. METHODS: We conducted 2 retrospective independent evaluations of Gavi’s HSS support in Cameroon and Chad using a mixed methodology. We investigated the chain of events and situations that increased the effort and time required to implement the HSS programs, decreased the value of the funds spent and hindered the sustainability of the implemented activities and gains achieved. RESULTS: Root causes affecting the efficiency and sustainability of HSS grants were common to Cameroon and Chad. Weaknesses in health workforce and leadership/governance of the health system in both countries led to interrupting the HSS grants, reprogramming them, almost doubling their implementation period, shifting their focus during implementation toward procurements and service provision, leaving both countries without solid exit plans to maintain the results gained. CONCLUSIONS: To increase the efficiency and sustainability of Gavi’s HSS grants, recipient countries need to consider health workforce and leadership/governance prior, or in parallel to strengthening other building blocks of their health systems. Williams & Wilkins 2018-05 2017-12-22 /pmc/articles/PMC5916462/ /pubmed/29278610 http://dx.doi.org/10.1097/INF.0000000000001848 Text en Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Original Studies Mimche, Honoré Squires, Ellen Miangotar, Yodé Mokdad, Ali El Bcheraoui, Charbel Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants |
title | Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants |
title_full | Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants |
title_fullStr | Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants |
title_full_unstemmed | Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants |
title_short | Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants |
title_sort | resource allocation strategies to increase the efficiency and sustainability of gavi’s health system strengthening grants |
topic | Original Studies |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5916462/ https://www.ncbi.nlm.nih.gov/pubmed/29278610 http://dx.doi.org/10.1097/INF.0000000000001848 |
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