Last data update: May 06, 2024. (Total: 46732 publications since 2009)
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Query Trace: Carnevale CR[original query] |
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Benefits and challenges of consolidating public health functions into a National Public Health Institute: A policy analysis
Carnevale CR , Woldetsadik MA , Shiver A , Gutierrez M , Chhea C , Ilori E , Jani I , MaCauley J , Mukonka V , Nsanzimana S , Ospina ML , Raji T , Spotts Whitney EA , Bratton S . Health Policy Plan 2023 38 (3) 342-350 National Public Health Institutes (NPHIs) around the world vary in composition. Consolidated organizational models can bring together critical functions such as disease surveillance, emergency preparedness and response, public health research, workforce development, and laboratory diagnosis within a single focal point. This can lead to enhanced coordination and management of resources and enable more efficient and effective public health operations. We explored stakeholders' perceptions about the benefits and challenges of consolidating public health functions in an NPHI in seven countries where the U.S. Centers for Disease Control and Prevention (CDC) has supported NPHI establishment and strengthening. From August 2019 through January 2020, we interviewed a total of 96 stakeholders, including NPHI staff (N=43), non-NPHI government staff (N=29), and non-governmental and international organization staff (N=24) in Cambodia, Colombia, Liberia, Mozambique, Nigeria, Rwanda, and Zambia. We conducted a policy analysis using Tea Collins's health policy analysis framework to assess various possible options for coordinating public health functions and their likely effectiveness. The findings can be used by policymakers as they consider public health infrastructure. We found that consolidating functions in an NPHI, to the extent politically and organizationally feasible, promotes efficiency, flexibility, and coordination, as well as supports data-driven health recommendations to government decision-makers. Countries pursuing NPHI establishment can weigh the potential challenges and benefits of consolidating functions when determining which public health functions will comprise the NPHI, including clarity of role, access to resources, influence over decisions, and political viability. |
Qualitative evaluation of enabling factors and barriers to the success and sustainability of national public health institutes in Cambodia, Colombia, Liberia, Mozambique, Nigeria, Rwanda and Zambia
Woldetsadik MA , Bratton S , Fitzpatrick K , Ravat F , Del Castillo L , McIntosh KJ , Jarvis D , Carnevale CR , Cassell CH , Chhea C , Prieto Alvarado F , MaCauley J , Jani I , Ilori E , Nsanzimana S , Mukonka VM , Baggett HC . BMJ Open 2022 12 (4) e056767 OBJECTIVES: The success of National Public Health Institutes (NPHIs) in low-income and middle-income countries (LMICs) is critical to countries' ability to deliver public health services to their populations and effectively respond to public health emergencies. However, empirical data are limited on factors that promote or are barriers to the sustainability of NPHIs. This evaluation explored stakeholders' perceptions about enabling factors and barriers to the success and sustainability of NPHIs in seven countries where the U.S. Centers for Disease Control and Prevention (CDC) has supported NPHI development and strengthening. DESIGN: Qualitative study. SETTING: Cambodia, Colombia, Liberia, Mozambique, Nigeria, Rwanda and Zambia. PARTICIPANTS: NPHI staff, non-NPHI government staff, and non-governmental and international organisation staff. METHODS: We conducted semistructured, in-person interviews at a location chosen by the participants in the seven countries. We analysed data using a directed content analysis approach. RESULTS: We interviewed 43 NPHI staff, 29 non-NPHI government staff and 24 staff from non-governmental and international organisations. Participants identified five enabling factors critical to the success and sustainability of NPHIs: (1) strong leadership, (2) financial autonomy, (3) political commitment and country ownership, (4) strengthening capacity of NPHI staff and (5) forming strategic partnerships. Three themes emerged related to major barriers or threats to the sustainability of NPHIs: (1) reliance on partner funding to maintain key activities, (2) changes in NPHI leadership and (3) staff attrition and turnover. CONCLUSIONS: Our findings contribute to the scant literature on sustainability of NPHIs in LMICs by identifying essential components of sustainability and types of support needed from various stakeholders. Integrating these components into each step of NPHI development and ensuring sufficient support will be critical to strengthening public health systems and safeguarding their continuity. Our findings offer potential approaches for country leadership to direct efforts to strengthen and sustain NPHIs. |
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