Browsing by Author "Singh, Neha S"

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    Lenses and levels: the why, what and how of measuring health system drivers of women’s, children’s and adolescents’ health with a governance focus
    (BMJ, 2019) George, Asha; LeFevre, Amnesty Elizabeth; Jacobs, Tanya; Kinney, Mary; Buse, Kent; Chopra, Mickey; Daelmans, Bernadette; Haakenstad, Annie; Huicho, Luis; Khosla, Rajat; Rasanathan, Kumanan; Sanders, David; Singh, Neha S; Tiffin, Nicki; Ved, Rajani; Zaidi, Shehla Abbas; Schneider, Helen
    Health systems are critical for health outcomes as they underpin intervention coverage and quality, promote users’ rights and intervene on the social determinants of health. Governance is essential for health system endeavours as it mobilises and coordinates a multiplicity of actors and interests to realise common goals. The inherently social, political and contextualised nature of governance, and health systems more broadly, has implications for measurement, including how the health of women, children and adolescents health is viewed and assessed, and for whom. Three common lenses, each with their own views of power dynamics in policy and programme implementation, include a service delivery lens aimed at scaling effective interventions, a societal lens oriented to empowering people with rights to effect change and a systems lens concerned with creating enabling environments for adaptive learning. We illustrate the implications of each lens for the why, what and how of measuring health system drivers across micro, meso and macro health systems levels, through three examples (digital health, maternal and perinatal death surveillance and review, and multisectoral action for adolescent health). Appreciating these underpinnings of measuring health systems and governance drivers of the health of women, children and adolescents is essential for a holistic learning and action agenda that engages a wider range of stakeholders, which includes, but also goes beyond, indicator-based measurement. Without a broadening of approaches to measurement and the types of research partnerships involved, continued investments in the health of women, children and adolescents will fall short.
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    A tale of ‘politics and stars aligning’: Analysing the sustainability of scaled up digital tools for front-line health workers in India
    (BMJ Publishing Group, 2021) Singh, Neha S; Scott, Kerry; LeFevre, Amnesty Elizabeth
    India has become a lighthouse for largescale digital innovation in the health sector, particularly for front-line health workers (FLHWs). However, among scaled digital health solutions, ensuring sustainability remains elusive. This study explores the factors underpinning scale-up of digital health solutions for FLHWs in India, and the potential implications of these factors for sustainability.We assessed five FLHW digital tools scaled at the national and/or state level in India. We conducted in-depth interviews with implementers, technology and technical partners (n=11); senior government stakeholders (n=5); funders (n=1) and evaluators/academics (n=3). Emergent themes were grouped according to a broader framework that considered the (1) digital solution; (2) actors; (3) processes and (4) context.