13 December, 2014

The Role of Accountability at the Frontlines in the Post MDG World

The Millennium Development Goals (MDGs) have been the guiding paradigm for much global health and development funding for the past nine years. 2015 is the target year for reaching the Goals. The United Nations, governments, international organizations, and activists are discussing what should guide post-2015 efforts. As part of this conversation, World Vision International convened a high level side event of the sixth session of the Open Working Group at the United Nations in New York. AMDD Director Lynn Freedman, as well as representatives from UNFPA, the World Bank’s Global Partnership for Social Accountability, and World Vision, spoke at the side event,Citizen Voices: How Citizen Participation and Social Accountability Can Drive Development Effectiveness, on Friday, December 13. Professor Freedman explained the importance of understanding and addressing complex local realities in devising global development goals. Acknowledging these realities is key to promoting authentic, effective social accountability.

9 October, 2014

AMDD amd Colleagues publish an article in the journal health policy and planning on disrespect and abuse during facility delivery

AMDD Director Lynn Freedman and Margaret Kruk, Director of the Better Health Systems Initiative, AMDD’s Stephanie Kujawski and Kate Ramsey and colleagues Godfrew Mbaruku and Wema Moyo of the Ifakara Health Institute, have published an article in the journal Health Policy and Planning entitled, “Disrespectful and abusive treatment during facility delivery in Tanzania: a facility and community survey.” The article discusses the authors’ research into the frequency of disrespectful and abusive experiences during facility childbirth in eight health facilities in rural Tanzania and associated factors, in an effort to establish reliable estimates for the prevalence of abusive experiences in these settings. The study found that between 19% and 28% of women in eight facilities in northeastern Tanzania experienced disrespectful and/or abusive treatment from health providers during childbirth. They frame this issue as a health system crisis that requires urgent solutions both to ensure women’s right to dignity in health care and to improve effective utilization of facilities for childbirth in order to reduce maternal mortality. The article can be accessed via Health Policy and Planning.

7 August, 2014

AMDD Review on the Use of Special and Emergency Hiring Approaches in Health Systems

In the context of its work on posting and transfer (P&T) in the health system, AMDD reviewed the use of special and emergency hiring approaches. Special and emergency hiring programs entail the use of processes and mechanisms that are outside of the primary, nationally institutionalized human resource frameworks. Specifically, this AMDD review sought to assess whether these approaches avert some of the challenges that undercut optimal deployment, long-term retention, and the rational assignment of transfers. Do efforts outside of the “regular” system bypass the P&T challenges of the “normal” system? Why? Click here to read this new AMDD review.   

27 June, 2014

AMDD Publishes a Comment in the Lancet Midwifery Series: Disrespect and abuse of women in childbirth: challenging the global quality and accountability agendas

AMDD Director Lynn Freedman and Margaret Kruk, Director of the Better Health Systems Initiative, have published a comment entitled, “Disrespect and abuse of women in childbirth: challenging the global quality and accountability agendas,” as part of the Lancet Midwifery Series. The article discusses the widespread and varied nature of disrespectful and abusive treatment (D&A) of women during childbirth in health facilities, and the complex challenge of defining D&A so that it may be measured and monitored. The authors present a definitional diagram of D&A, developed by AMDD and its partners to represent the complexities of D&A at the individual, systemic, and policy levels, towards improving quality and accountability across this spectrum. Reducing the presence of D&A across health systems improves the interactions with health facilities that effect women’s decisions about where to deliver, with direct implications for quality of care. The article can be read in PDF format here or accessed as a full text via the Lancet, after free registration with their site.

16 April, 2014

AMDD and PHFI Issue Final Report on Bellagio Meeting on Posting and Transfer Practices in the Health Sector

AMDD and the Public Health Foundation of India (PHFI) organized a meeting on posting and transfers in the health sector at the Rockefeller Foundation’s Bellagio Center in February, 2014. A dynamic group of researchers, policymakers, and advocates attended the meeting. The final report has been completed and can be downloaded here. The Bellagio conference was a forum to share existing research, advance a joint understanding of posting and transfer, facilitate future research, and discuss strategies for influencing laws, policies, and programs. The final report details country experiences with posting and transfer within the health sector, networks for research and advocacy around P&T, and implications for research.

10 February, 2014

AMDD and the Public Health Foundation of India hold a Bellagio Conference on Posting and Transfer Practices in the Health Sector

AMDD and the Public Health Foundation of India (PHFI) organized a three-day conference at the Rockefeller Foundation’s Bellagio Center in February on posting and transfer practices for health care workers and administrators in low and middle-income countries. The meeting brought together an inter-disciplinary group of health systems researchers, national and international policymakers, journal editors, and NGOs from five continents to advance a shared understanding of posting and transfer, facilitate planning on future research, and create a roadmap to take the issue forward.

The current practice of assigning posts and granting transfers to health care workers and administrators in many countries perpetuates a system of inefficiency, abuse of power, and patronage that can undermine population health goals. These practices contribute to the maldistribution of health care workers, undermining progress towards universal health coverage.  Though poor posting and transfer practice is widespread, it is not openly addressed and academic enquiry has been limited by the inadequacy of existing frameworks to understand the issue. AMDD began studying posting and transfer in 2012 and supported an initial international consultation with PHFI the following year to create an India-specific research plan. Stemming from this, AMDD undertook a comprehensive literature review that was published in Health Policy and Planning.  The Bellagio conference was an important forum to share existing research, advance a joint understanding of posting and transfer, facilitate future research, and discuss strategy for influencing laws, policies, and programs.

Two Emerging Voices fellows attended the conference. Advanced doctoral students from Sub-Saharan Africa, the Fellows lent their regional expertise, open mindedness, and enthusiasm to the Conference. Read the blog post they authored on the experience here.

See a longer summary of the meeting discussion here.

2 February, 2014

AMDD and SAHAYOG Publish Technical Brief Detailing Experiences in the Technical Setup of 'Mera Swasthya, Meri Awaaz' (My Health, My Voice) Project

AMDD and the grassroots NGO, SAHAYOG, have composed a brief detailing experiences in the technical setup of 'Mera Swasthya, Meri Awaaz' (My Health, My Voice), a project which uses mobile phone technology to gather and leverage data on illicit fees charged for maternal health care in India. The SAHAYOG project combines mobile phones and Ushahidi, a popular platform for crowd-sourced “social good” projects. The model requires a mobile phone, and in contrast to many projects using mobile phones for reporting bribes or other events, it relies on interactive voice response (IVR) as opposed to text.

The successes and shortcomings of the technical implementation of this project will be potentially helpful to other organizations which, like SAHAYOG, are not largely technologically oriented. This brief outlines the setup and management of the reporting system used, as well as lessons learned and recommendations for future implementation. View the technical brief here.

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