Browsing by Author "Erasmus, Ermin"

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    Health policy and systems research: needs, challenges and opportunities in South Africa – a university perspective
    (Health systems trust, 2013) Marsha, Orgill; Nonhlanhla, Nxumalo; Woldekidan K., Amde; Uta, Lehmann; Jane, Goudge; Lucy, Gilson; Erasmus, Ermin
    The last two decades have seen growing international recognition of the need to strengthen health systems in order to deliver already available, cost-effective health interventions. This chapter describes the parallel global growth of the field of Health Policy and Systems Research (HPSR) and outlines what this field of research is and what it is not. The chapter also clarifies how HPSR can contribute to strengthening health systems. The particular relevance of HPSR in SA is discussed, given the range of health system transformation initiatives in place. Drawing both on an HPSR capacity assessment conducted in three universities and discussions with a wider group of researchers and health system managers, the chapter also considers the existing assets for and challenges facing the development of the field in South Africa. It closes with suggested strategies and priorities for developing and building capacity in this field nationally.
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    Mapping the existing body of health policy implementation research in lower income settings: what is covered and what are the gaps?
    (Oxford University Press (OUP), 2014) Erasmus, Ermin; Orgill, Marsha; Schneider, Helen; Gilson, Lucy
    This article uses 85 peer-reviewed articles published between 1994 and 2009 to characterize and synthesize aspects of the health policy analysis literature focusing on policy implementation in low- and middle-income countries (LMICs). It seeks to contribute, first, to strengthening the field of LMIC health policy analysis by highlighting gaps in the literature and generating ideas for a future research agenda and, second, to thinking about the value and applicability of qualitative synthesis approaches to the health policy analysis field. Overall, the article considers the disciplinary perspectives from which LMIC health policy implementation is studied and the extent to which the focus is on systems or programme issues. It then works with the more specific themes of the key thrusts of the reviewed articles, the implementation outcomes studied, implementation improvement recommendations made and the theories used in the reviewed articles. With respect to these more specific themes, the article includes explorations of patterns within the themes themselves, the contributions of specific disciplinary perspectives and differences between systems and programme articles. It concludes, among other things, that the literature remains small, fragmented, of limited depth and quite diverse, reflecting a wide spectrum of health system dimensions studied and many different suggestions for improving policy implementation. However, a range of issues beyond traditional ‘hardware’ health system concerns, such as funding and organizational structure, are understood to influence policy implementation, including many ‘software’ issues such as the understandings of policy actors and the need for better communication and actor relationships. Looking to the future, there is a need, given the fragmentation in the literature, to consolidate the existing body of work where possible and, given the often broad nature of the work and its limited depth, to draw more explicitly on theoretical frames and concepts to deepen work by sharpening and focusing concerns and questions.
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    Strengthening post-graduate educational capacity for health policy and systems research and analysis: the strategy of the Consortium for Health Policy and Systems Analysis in Africa
    (BioMed Central, 2016) Lehmann, Uta; Erasmus, Ermin
    BACKGROUND: The last 5–10 years have seen significant international momentum build around the field of health policy and systems research and analysis (HPSR + A). Strengthening post-graduate teaching is seen as central to the further development of this field in low- and middle-income countries. However, thus far, there has been little reflection on and documentation of what is taught in this field, how teaching is carried out, educators’ challenges and what future teaching might look like. METHODS: Contributing to such reflection and documentation, this paper reports on a situation analysis and inventory of HPSR + A post-graduate teaching conducted among the 11 African and European partners of the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA), a capacity development collaboration. A first questionnaire completed by the partners collected information on organisational teaching contexts, while a second collected information on 104 individual courses (more in-depth information was subsequently collected on 17 of the courses). The questionnaires yielded a mix of qualitative and quantitative data, which were analysed through counts, cross-tabulations, and the inductive grouping of material into themes. In addition, this paper draws information from internal reports on CHEPSAA’s activities, as well as its external evaluation. RESULTS: The analysis highlighted the fluid boundaries of HPSR + A and the range and variability of the courses addressing the field, the important, though not exclusive, role of schools of public health in teaching relevant material, large variations in the time investments required to complete courses, the diversity of student target audiences, the limited availability of distance and non-classroom learning activities, and the continued importance of old-fashioned teaching styles and activities. CONCLUSIONS: This paper argues that in order to improve post-graduate teaching and continue to build the field of HPSR + A, key questions need to be addressed around educational practice issues such as the time allocated for HPSR + A courses, teaching activities, and assessments, whether HPSR + A should be taught as a cross-cutting theme in post-graduate degrees or an area of specialisation, and the organisation of teaching given the multi-disciplinary nature of the field. It ends by describing some of CHEPSAA’s key post-graduate teaching development activities and how these activities have addressed the key questions.