Systematic review: Towards resilient health systems in sub-Saharan Africa

29 December, 2019

This systematic review concludes: 'Any country health system that trains a cadre of health professionals on the job, reduces health workforce attrition levels, and builds local capacity for health care workers to apply innovative mHealth technologies improves health sector performance.'

CITATION: Ayanore MA, Amuna N, Aviisah M, Awolu A, Kipo-Sunyehzi DD, Mogre V, et al. Towards resilient health systems in sub-Saharan Africa: A systematic review of the English language literature on health workforce, surveillance, and health governance issues for health systems strengthening. Annals of Global Health. 2019;85(1):113

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696789/pdf/agh-85-1-2514.pdf

ABSTRACT

BACKGROUND: Meeting health security capacity in sub-Saharan Africa will require strengthening existing health systems to prevent, detect, and respond to any threats to health. The purpose of this review was to examine the literature on health workforce, surveillance, and health governance issues for health systems strengthening.

METHODS: We searched PubMed, Science Direct, Cochrane library, CINAHL, Web of Science, EMBASE, EBSCO, Google scholar, and the WHO depository library databases for English-language publications between January 2007 and February 2017. Electronic searches for selected articles were supplemented by manual reference screening. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS: Out of 1,548 citations retrieved from the electronic searches, 31 articles were included in the review. Any country health system that trains a cadre of health professionals on the job, reduces health workforce attrition levels, and builds local capacity for health care workers to apply innovative mHealth technologies improves health sector performance. Building novel surveillance systems can improve clinical care and improve health system preparedness for health threats. Effective governance processes build strong partnerships for health and create accountability mechanisms for responding to health emergencies.

CONCLUSIONS: Overall, policy shifts in African countries' health systems that prioritize training a cadre of willing and able workforce, invest in robust and cost-effective surveillance capacity, and create financial accountability and good governance are vital in health strengthening efforts.

Best wishes, Neil

Coordinator, HIFA Project on Evidence-Informed Policy and Practice

http://www.hifa.org/projects/evidence-informed-policy-and-practice

Coordinator, mHIFA Project (Mobile Healthcare Information For All) - Supported by HIFA members

http://www.hifa.org/projects/mobile-hifa-mhifa

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org