Gateway Current Issues In Healthcare Reporting Quality Of Care Case Study

Gateway Current Issues In Healthcare Reporting Quality Of Care Case Study

Gateway Current Issues In Healthcare Reporting Quality Of Care Case Study

The underdeveloped healthcare systems in Africa need radical solutions with innovative thought to break the current impasse in service delivery. For example, public-private initiatives should be sought, where multinational companies extracting resources from Africa might be encouraged to plough some of the profits back into healthcare for the communities providing the workforce for their commercial activities. Most problems and their solutions lie within human resources, budget allocation and management. These should be accorded the highest priority for better health outcomes.

Keywords: Africa, healthcare management, human resources, health systems

gateway current issues in healthcare reporting quality of care case study

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Introduction

Globally, countries are faced with health system problems which vary from one to the next. While health service delivery challenges are more often seen in countries with a very high Human Development Index (HDI), human resources challenges attract more attention within those with a low HDI.1 Healthcare systems in Africa have, over the years, suffered from man-made issues which cut across institutional, human resources, financial, technical and political developments. With this in mind, the World Health Organization (WHO) in 2007 proposed a framework that describes healthcare systems in terms of six core components or “building blocks”: i) service delivery; ii) healthcare workforce; iii) healthcare information systems; iv) medicines and technologies; v) financing; and vi) leadership/governance.2 The majority of African countries are unable to meet the basic requirement for good healthcare systems. Poor governance and human resource challenges are linked to ineffective integration of services in resource-limited nations.35

Dilapidated healthcare systems have facilitated medical tourism, for example, leading to over 5000 people leaving Nigeria every month for various forms of treatment abroad and about 1.2 billion US dollars lost from the Nigerian economy to medical tourism yearly.6 Other healthcare system problems prevalent in Africa include financial barriers to healthcare services with high rates of out-of-pocket expenditure, owing to ineffective national health insurance systems,79 and poor service integration.3,8 Human resources shortages and “brain drainage” from Africa to Europe, the Middle East and North America compound healthcare outcomes.911 Healthcare sector industrial action (healthcare worker strikes) is frequent in Nigeria, where it has complicated most aspects of the healthcare service delivery1014 and consequently prevented optimal healthcare delivery to the Nigerian population.15

As part of efforts to remedy the lack of financial risk protection mechanisms in Africa, some countries, such as Nigeria, Ghana, Tanzania, Kenya, Rwanda and Ethiopia have started implementing social health insurance schemes.79 However, the majority of people still suffer financial barriers as out-of-pocket expenditure is required before medical care can be provided, even in emergency situations and importantly, many insurance programs leave out the poor.16 The poor therefore bear the highest burden of diseases and experience high levels of financially crippling healthcare expenditure in many sub-Saharan African countries.16,17 In countries like Nigeria, non-implementation of relevant policies, programs and agreements between government and the various healthcare workers have frequently led to employee industrial action and periodic refusal to provide healthcare services to the sick.10,11

Several studies have documented key healthcare system challenges globally with recommended solutions. However, challenges that healthcare systems in Africa face require in-depth exploration to identify, generate and implement contextual solutions that make significant population-level health gains with efficient use of resources.18 In order to bridge this information gap, the authors used the opportunity of a gathering of key opinion leaders at a recent African Epidemiological Association Annual Meeting in Maputo (with participants drawn from various countries in Africa) to identify perceived unmet needs in African healthcare systems and suggest ways of addressing them. This was done to determine healthcare system challenges which were most worrisome to principal African policy makers and implementers across Africa, as well as to identify major ways these challenges could be effectively addressed.

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