Clear all

155 results found

reorder grid_view

From Pollution to Solution in Six African Cities (French Version)

November 23, 2023

La pollution de l'air est un véritable fléau silencieux pour l'Afrique. Chaque année, l'air pollué tue plus d'Africains que l'eau insalubre, l'assainissement et le lavage des mains combinés. En plus du million d'Africains qui meurent chaque année de la pollution de l'air provenant de sources intérieures et extérieures, des millions d'autres vies doivent vivre avec ses conséquences dévastatrices. La situation est bien pire dans les villes, où les activités hautement polluantes nuisent à la santé des habitants et à l'économie. Une étude réalisée par Dalberg Advisors pour le Clean Air Fund révèle que si rien n'est fait, la pollution de l'air coûtera collectivement à Accra, au Caire, à Johannesburg, à Lagos, à Nairobi et à Yaoundé environ 138 milliards de dollars US en décès prématurés et en absentéisme des travailleurs d'ici à 2040, ce qui représente 8 % de leurs PIB actuels combinés.L'urbanisation rapide du continent ne devrait pas se faire au détriment de la santé de ses citoyens. Les villes africaines peuvent opter pour une croissance verte, dans laquelle les investissements visant à lutter contre les principales sources de pollution atmosphérique contribuent à améliorer la productivité des travailleurs et les budgets nationaux de santé, et à créer des lieux de vie sains, équitables et prospères. Les gouvernements africains prennent de plus en plus conscience de l'importance cruciale de ce défi. L'Évaluation environnementale intégrée en Afrique présente les mesures nécessaires pour parvenir à une croissance verte, mais la mise en œuvre de ce projet pour l'Afrique nécessite une action plus globale, coordonnée et à plus grande échelle. Cette analyse indique que dans les six villes étudiées, des mesures prises aujourd'hui pourraient permettre d'éviter 109 000 décès prématurés et la perte de 19 milliards de dollars US d'ici à 2040.Se fondant sur des études de cas de meilleures pratiques à travers le continent africain, cette note stratégique formule des recommandations susceptibles d'aider les gouvernements à favoriser une croissance économique verte en milieu urbain. Pour relever ce défi, il est essentiel d'investir dans la bonne gouvernance et la législation, d'améliorer le suivi de la qualité de l'air, de mener des politiques de réduction des émissions scientifiquement fondées, de mettre en place des modèles de partenariat et des formations efficaces, et d'améliorer l'accès au financement de la lutte contre le changement climatique. Ces recommandations représentent la première étape de conception et de mise en œuvre d'actions adaptées au niveau local que les gouvernements doivent prendre en compte.Air pollution is Africa's silent killer. Each year, air pollution kills more Africans than HIV / AIDS and malaria combined. In addition to the 1 million Africans who die from diseases caused by indoor and outdoor sources of air pollution annually, millions more have to live with its devastating consequences. This problem is worse in cities, where highly polluting activities stunt the health of both their residents and economies. Analysis undertaken for the Clean Air Fund by Dalberg Advisors finds that left unchecked, air pollution will collectively cost Accra, Cairo, Johannesburg, Lagos, Nairobi and Yaoundé an estimated US$138bn in premature deaths and worker absenteeism by 2040, equivalent to 8% of their current combined GDPs.The continent's rapid urban growth should not come at the expense of the health of its citizens. African cities can choose to put themselves on the path of green growth, in which investments to tackle the major sources of air pollution bring about benefits to worker productivity, national health budgets and help create healthy, equitable and prosperous places to live. African governments are increasingly aware of this challenge. The Africa Integrated Assessment outlines the steps needed to reach green growth, but realising this blueprint for Africa requires more comprehensive, coordinated and scaled action. This analysis shows that across the six case study cities, actions taken today could prevent 109,000 premature deaths and prevent the loss of US$19bn by 2040.Drawing on best-practice case studies from across the African continent, this policy brief lays out recommendations that can help governments unleash green urban economic growth. Investments in good governance and legislation, better air quality monitoring, evidence-based emission reduction policies, effective partnership models and training, and improved access to climate financing are essential to meeting this challenge. These recommendations represent the first step for governments to consider as they design and deliver locally-tailored action.

From Pollution to Solution in Six African Cities

November 23, 2023

Air pollution is Africa's silent killer. Each year, air pollution kills more Africans than HIV / AIDS and malaria combined. In addition to the 1 million Africans who die from diseases caused by indoor and outdoor sources of air pollution annually, millions more have to live with its devastating consequences. This problem is worse in cities, where highly polluting activities stunt the health of both their residents and economies. Analysis undertaken for the Clean Air Fund by Dalberg Advisors finds that left unchecked, air pollution will collectively cost Accra, Cairo, Johannesburg, Lagos, Nairobi and Yaoundé an estimated US$138bn in premature deaths and worker absenteeism by 2040, equivalent to 8% of their current combined GDPs.The continent's rapid urban growth should not come at the expense of the health of its citizens. African cities can choose to put themselves on the path of green growth, in which investments to tackle the major sources of air pollution bring about benefits to worker productivity, national health budgets and help create healthy, equitable and prosperous places to live. African governments are increasingly aware of this challenge. The Africa Integrated Assessment outlines the steps needed to reach green growth, but realising this blueprint for Africa requires more comprehensive, coordinated and scaled action. This analysis shows that across the six case study cities, actions taken today could prevent 109,000 premature deaths and prevent the loss of US$19bn by 2040.Drawing on best-practice case studies from across the African continent, this policy brief lays out recommendations that can help governments unleash green urban economic growth. Investments in good governance and legislation, better air quality monitoring, evidence-based emission reduction policies, effective partnership models and training, and improved access to climate financing are essential to meeting this challenge. These recommendations represent the first step for governments to consider as they design and deliver locally-tailored action.

CTAP Final Report: The COVID-19 Transparency and Accountability Journey So Far

May 1, 2023

The pandemic has both exacerbated and exposed existing health sector challenges across the world. During the second phase of the COVID-19 Transparency and Accountability Project (CTAP), partners across 9 African countries utilized the multiple challenges of the crisis as a window of opportunity to advance health policy priorities.The organizations leading the CTAP work on the ground pivoted to create inclusive platforms for citizens to be informed and heard at the grassroots level, build coalitions with other CSOs to have greater collective impact, and call on governments for change through advocacy, and increasingly, collaboration to design and implement better policies going forward.This report provides a brief overview of what we did and what we learned, illustrative snapshots from each CTAP partner country, as well as insights into cross-country collaboration and the way forward. Together with our partners CODE and BudgIT, Global Integrity has helped to facilitate the CTAP journey since 2020 and served as a learning partner for the implementing organizations in Africa.

Default The Role of CSOs in Climate Action Through Informal Climate Change Learning in Ghana

April 29, 2023

Climate change is real, and the impacts are all around us. Reports from the Inter-governmental Panel on Climate Change (IPCC) reveal the current changes in climate as a result of human activities. Climate change therefore affects everyone but developing countries including Ghana will face a greater burden of climate change as a result of existing challenges including poverty, health, sanitation among others. All stakeholders including the state and non-state actors have a role to play towards achieving ambitious climate change targets. Civil Society Organisations (CSOs) continue to play a key role in promoting climate action and empowering vulnerable communities on how to adapt and build resilience against climate change. However, the role of CSOs in climate action has received less attention and documented especially in Ghana. This study aims to address this gap by examining the role of CSOs in promoting climate change learning through informal methods. It specifically identifies climate change informal learning platforms used by CSOs to promote climate change learning in communities, how these methods used by CSOs increase people's knowledge on climate change, climate change adaptation and mitigation, promotes eco-friendly practices and the challenges CSOs face using these methods.

From “Innovation for Localization” to “Local Philanthropy, Localization and Power”

November 17, 2022

n 2021, five organizations – Save the Children Denmark, Network for Empowered Aid Response (NEAR), West Africa Civil Society Institute (WACSI), STAR Ghana Foundation (SGF) and the Global Fund for Community Foundations (GFCF) participated in an ambitious and experimental joint project.The aim of the project was to "test durable, locally rooted funding mechanisms" in Somalia and Ghana, with the broader purpose of contributing – by demonstration – to efforts within the international humanitarian aid and development sector to transform and localize aid. The purpose of this learning report, curated by the GFCF, is to capture some of the main insights and reflections ofthe participating organizations and to consider the broader implications of and lessons from the project. It focuses on the experiences of those involved and the larger question of how unorthodox configurations of actors and new and different kinds of partnerships might contribute towards transformative change within the international aid system. 

“You Can’t Look at an Orange and Draw a Banana”: Using Research Evidence to Develop Relevant Health Policy in Ghana

September 15, 2022

We examined factors that either enabled or inhibited the process of evidence-based decision making regarding health policy in Ghana. We conducted qualitative interviews with 2 major groups of stakeholders: health policy and systems research producers (research producers [RPs]) and policy makers (PMs). In-depth interviews were conducted with 12 RPs, who were representatives from 11 health policy and systems research institutions; and 12 PMs working in various national health-related agencies, ministries, and departments. We analyzed the data using the thematic analysis approach. Interview results showed 5 recurring themes in their discussion of enablers and inhibitors of the evidence-to-policy process: (1) the quality, relevance, and quantity of available research evidence; (2) how findings are communicated to PMs; (3) the strength of relationships between RPs and PMs; (4) available structures that promote evidence-based policy making; and (5) the political context in which research and policy making occurs. These findings point to some specific areas for further collaboration and communication among Ghanaian stakeholders to ensure that appropriate health policies are developed from an evidence base.

Using Health Systems and Policy Research to Achieve Universal Health Coverage in Ghana

September 15, 2022

Ghana is positioned to become the first country in sub-Saharan Africa to implement universal health coverage based on nationwide expansion of geographic access through the Community-based Health Planning and Services initiative. This achievement is the outcome of 3 decades of implementation research that health authorities have used for guiding the development of its primary health care program. This implementation research process has comprised Ghana's official endorsement of the 1978 Alma Ata Declaration, leading to the institutionalization of evidence relevant to the strategic design of primary health care and national health insurance policies and services. Rather than relying solely upon the dissemination of project results, Ghana has embraced a continuous and systemic process of knowledge capture, curation, and utilization of evidence in expanding geographic access by a massive expansion in the number of community health service points that has taken decades. A multisectoral approach has been pursued that has involved the creation of systematic partnerships that included all levels of the political system, local development officials, community groups and social networks, multiple university-based disciplines, external development partners, and donors. However, efforts to achieve high levels of financial access through the roll-out of the National Health Insurance Scheme have proceeded at a less consistent pace and been fraught with many challenges. As a result, financial access has been less comprehensive than geographical access despite sequential reforms having been made to both programs. The legacy of activities and current research on primary health care and national health insurance are reviewed together with unaddressed priorities that merit attention in the future. Factors that have facilitated or impeded progress with research utilization are reviewed and implications for health systems strengthening in Ghana and elsewhere in Africa and globally are discussed.

Health Policy and Systems Research Capacities in Ethiopia and Ghana: Findings From a Self-Assessment

September 15, 2022

Introduction: Health systems are complex. Policies targeted at health system development may be informed by health policy and systems research (HPSR). This study assesses HPSR capacity to generate evidence and inform policy in Ethiopia and Ghana.Methods: We used a mixed-methods approach including a self-administered survey at selected HPSR institutes and in-depth interviews of policy makers.Results: Both countries have limited capacity to generate HPSR evidence, especially in terms of mobilizing adequate funding and retaining a critical number of competent researchers who understand complex policy processes, have the skills to influence policy, and know policy makers' demands for evidence. Common challenges are limited government research funding, rigidity in executing the research budget, and reliance on donor funding that might not respond to national health priorities. There are no large research programs in either country. The annual number of HPSR projects per research institute in Ethiopia (10 projects) was higher than in Ghana (2.5 projects), Ethiopia has a significantly smaller annual budget for health research. Policy makers in the 2 countries increasingly recognize the importance of evidence-informed policy making, but various challenges remain in building effective interactions with HPSR institutes.Conclusion: We propose 3 synergistic recommendations to strengthen HPSR capacity in Ethiopia and Ghana. First, strengthen researchers' capacity and enhance their opportunities to know policy actors; engage with the policy community; and identify and work with policy entrepreneurs, who have attributes, skills, and strategies to achieve a successful policy. Second, deliver policy-relevant research findings in a timely way and embed research into key health programs to guide effective implementation. Third, mobilize local and international funding to strengthen HPSR capacities as well as address challenges with recruiting and retaining a critical number of talented researchers. These recommendations may be applied to other low- and middle-income countries to strengthen HPSR capacities.

Barriers and Facilitators to Data Use for Decision Making: The Experience of the African Health Initiative Partnerships in Ethiopia, Ghana, and Mozambique

September 15, 2022

Background: Three African Health Initiative (AHI) partnership projects in Ethiopia, Ghana, and Mozambique implemented strategies to improve the quality and evaluation of routinely collected data at the primary health care level and stimulate its use in evidence-based decision making. We compare how these programs designed and carried out data for decision-making (DDM) strategies, elaborate on barriers and facilitators to implementation success, and offer recommendations for future DDM programming.Methods: Researchers from each project collaboratively wrote a cross-country protocol based on these objectives. By adapting the Consolidated Framework for Implementation Research (CFIR) through a qualitative theme reduction process, they harmonized lines of inquiry on the design of the respective DDM strategies and the barriers and facilitators of effective implementation. We conducted in-depth interviews and focus group discussions with stakeholders from the primary health care systems in each country, and we carried out multistage, thematic analyses using a deductive lens.Results: Effective implementation of DDM depended on whether implementers felt that DDM was adaptable to context, feasible to trial, and easy to introduce and maintain. The prevailing policy and political environment in the wider health system, learning climate and absorptive capacity for evidence-based change in DDM settings, engagement of external change agents and internal change leaders, and promotion of opportunities and means for team-based reflection and evaluations of what works influenced the success or failure of DDM strategies.Conclusion: Opportunities for team-based capacity building and individual mentorship led to effective DDM programming. External policies and associated incentives bolstered this but occasionally led to unintended consequences. Leadership engagement and availability of resources to act on recommendations; respond to capacity-building needs; and facilitate collaborations between peers, within hierarchies, and across the local health system proved crucial to DDM, as was encouraging adaptation and opportunities for iterative on-the-job learning.

Improving Primary Care Quality Through Supportive Supervision and Mentoring: Lessons From the African Health Initiative in Ethiopia, Ghana, and Mozambique

September 15, 2022

Introduction: Supportive supervision and mentoring (SSM) is crucial to primary care quality and effectiveness. Yet, there is little clarity on how to design and implement SSM and make it sustainable in primary health care (PHC) systems. The 3 African Health Initiative partnership projects introduced strategies to do this in Ethiopia, Ghana, and Mozambique. We describe: (1) how each partnership adapted SSM implementation strategies, (2) the dynamics of implementation and change that ensued after intervening within PHC systems, and (3) insights on the SSM sustainability as a mainstay of PHC.Methods: Researchers from each project collaboratively wrote a cross-country protocol based on those objectives. For this, they adapted implementation science frameworks—the Exploration, Preparation, Implementation, and Sustainment model and the Consolidated Framework for Implementation Research—through a qualitative theme reduction process. This resulted in harmonized lines of inquiry on the design, implementation, and potential sustainability of each project's SSM strategy. In-depth interviews and focus group discussions were conducted with stakeholders from PHC systems in each country and thematic analyses ensued.Results: Across the projects, SSM strategies acquired multiple components to address individual, systems, and process-related determinants. Benefits arose from efforts that addressed worker-level attitudes and barriers, promoted a wider learning environment, and enhanced collaborative structures and tools for monitoring performance. Peer exchanges and embedded implementation research were critical to the perceived effectiveness of SSM strategies.Discussion: Despite differences in their approach to SSM implementation, there are common crucial ingredients across the SSM strategies of the 3 AHI partner projects from which important lessons arise: (1) positioning learning and adaptation opportunities within the routine workings of PHC systems, facilitation, and technical support to reflect and utilize new knowledge; (2) multisectoral collaboration, particularly with academic organizations; and (3) building PHC decision-makers' and implementation teams' capacity for evidence-informed change.

Embedding Research on Implementation of Primary Health Care Systems Strengthening: A Commentary on Collaborative Experiences in Ethiopia, Ghana, and Mozambique

September 15, 2022

Achieving universal health care coverage requires the adoption of primary health care policies and delivery strategies that are evidence based. Although this has been confronted by manifold challenges, particularly in the health systems of sub-Saharan Africa, there are promising approaches for accomplishing this objective. Salient among these is embedding implementation research (i.e., the study of methods to promote the systematic uptake of evidence-based interventions (EBIs) into routine practice) into policy making and implementation processes. Since 2007, the African Health Initiative of the Doris Duke Charitable Foundation supported partnerships that strengthened primary health systems and policy implementation in 7 countries in sub-Saharan Africa using the embedded implementation research as a core strategy. This programmatic review and analysis aims to identify the core features and processes that characterized how the partnerships operationalized the embedded implementation research approach and understand the factors that helped and constrained partnerships' effective use of this approach. For this, we drew upon findings from a desk review that consisted of 30 examples of embedded implementation research conducted by 3 African Health Initiative partnerships between 2016 and 2021 in Ethiopia, Ghana, and Mozambique. In addition, we conducted and analyzed 13 in-depth interviews with embedded implementation research stakeholders of the 3 projects.Core features and processes of embedded implementation research were: (1) the leadership role of policy decision makers and implementation leaders; (2) positioning research with program implementation at multiple levels of health systems; (3) multidisciplinary and multisectoral partnerships; (4) focus on research capacity building; and (5) real-time feedback loops and knowledge translation.Factors influencing the effectiveness of the embedded implementation research experiences involved: (1) the implementation climate and leadership; (2) opportunities and capacities to circulate and absorb new information; and (3) stakeholders' baseline knowledge and embedded scientists' identification within their organizations.

Learning Health Systems to Bridge the Evidence-Policy-Practice Gap in Primary Health Care: Lessons From the African Health Initiative

September 15, 2022

The authors provide a brief history of the African Health Initiative and introduce the articles of the Global Health: Science and Practice journal supplement, highlighting the importance of evidence-based interventions (EBI) in global health and summarizing key takeaways.