Fixing Health Systems

by De Savigny, Don

• ISBN13: 9781552504093
• ISBN10: 1552504093
• Edition: 2nd
• Format: Paperback
• Copyright: 2008-07-01
• Publisher: STYLUS PUBLISHING LLC

Summary

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 Systemsrevealed, 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.

Author Biography

Graham Reid is now Senior Program Specialist at IDRC's office in Nairobi. Conrad Mbuya, formerly TEHIP Project Coordinator, is 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. Harun Kasale, formerly TEHIP Project Coordinator, is 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. Don de Savigny is now Head of the Health Systems Interventions Research Unit at the Swiss Tropical Institute.

Table of Contents

Foreword
The Idea	p. 1
A history of hope and struggle	p. 5
Bold new initiatives	p. 7
TEHIP's piece of the puzzle	p. 9
Testing a potent idea	p. 12
Complexity anchored by fundamental questions	p. 16
The need for an integrated approach	p. 18
Efficiency leads to equity	p. 22
The Approach	p. 25
Integrating research and development	p. 27
The consortium approach	p. 29
The research begins	p. 30
The Demographic Surveillance System	p. 33
The evolution of the tools	p. 36
The Results	p. 45
Supplementary funding	p. 47
Capacity building in management and administration	p. 49
The Integrated Management Cascade	p. 50
Rehabilitation of health facilities	p. 55
What the districts did with budget planning tools	p. 57
A new assault on disease	p. 60
Integrated Management of Childhood Illnesses	p. 66
Conclusion	p. 70
Extending TEHIP's Innovation and Impact	p. 71
Lessons Learned	p. 77
General principles	p. 78
People	p. 79
Infrastructure	p. 79
Governance	p. 80
Information	p. 81
Conclusion	p. 82
Epilogue. TEHIP Maintains its Momentum	p. 85
Acknowledgments	p. 103
Glossary of Terms and List of Acronyms	p. 111
Sources and Resources	p. 119
Table of Contents provided by Blackwell. All Rights Reserved.