Browsing by Author "Theobald, Sally"

Now showing 1 - 6 of 6
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    Decision space for health workforce management in decentralized settings: a case study in Uganda
    (Health Policy and Planning, 2017) Alonso-Garbayo, Alvaro; Raven, Joanna; Theobald, Sally; Ssengooba, Freddie; Nattimba, Milly; Martineau, Tim
    The aim of this paper is to improve understanding about how district health managers perceive and use their decision space for human resource management (HRM) and how this compares with national policies and regulatory frameworks governing HRM. The study builds upon work undertaken by PERFORM Research Consortium in Uganda using action-research to strengthen human resources management in the health sector. To assess the decision space that managers have in six areas of HRM(e.g. policy, planning, remuneration and incentives, performance management, education and information) the study compares the roles allocated by Uganda’s policy and regulatory frameworks with the actual room for decision-making that district health managers perceive that they have. Results show that in some areas District Health Management Team (DHMT) members make decisions beyond their conferred authority while in others they do not use all the space allocated by policy. DHMT members operate close to the boundaries defined by public policy in planning, remuneration and incentives, policy and performance management. However, theymake decisions beyond their conferred authority in the area of information and do not use all the space allocated by policy in the area of education. DHMTs’ decision-making capacity to manage their workforce is influenced by their own perceived authority and sometimes it is constrained by decisions made at higher levels. We can conclude that decentralization, to improve workforce performance, needs to devolve power further down from district authorities onto district health managers. DHMTs need not only more power and authority to make decisions about their workforce but also more control over resources to be able to implement these decisions.
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    Fragile and conflict affected states: report from the Consultation on Collaboration for Applied Health Research and Delivery
    (Conflict and Health, 2014) Raven, Joanna; Martineau, Tim; MacPherson, Eleanor; Dieu-Merci, Amuda Baba; Ssali, Sarah; Torr, Steve; Theobald, Sally
    Fragile and Conflict Affected States present difficult contexts to achieve health system outcomes and are neglected in health systems research. This report presents key debates from the Consultation of the Collaboration for Applied Health Research and Delivery, Liverpool, June, 2014.
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    Gender equality needs critical consideration in conflict-affected settings
    (Development in Practice, 2015) Richards, Esther; Percival, Valerie; Ssali, Sarah; Theobald, Sally
    The World Bank’s 2012 World Development Report calls for gender equality on a global level but falls short on its analysis of conflict-affected contexts. It is critical that we understand the needs of vulnerable populations in these settings. This viewpoint draws on findings from research in health reform in conflict-affected contexts to highlight some opportunities and challenges for addressing gender equality in these settings, using the policy priorities outlined in the World Bank report. Drawing on this analysis we argue that more attention and action should be focused on addressing gender inequalities and inequities in neglected conflict-affected states.
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    The importance of gender analysis in research for health systems strengthening
    (Oxford University Press, 2017) Theobald, Sally; Morgan, Rosemary; Hawkins, Kate; Ssali, Sarah; George, Asha; Molyneux, Sassy
    This editorial discusses a collection of papers examining gender across a range of health policy and systems contexts, from access to services, governance, health financing, and human resources for health. The papers interrogate differing health issues and core health systems functions using a gender lens. Together they produce new knowledge on the multiple impacts of gender on health experiences and demonstrate the importance of gender analyses and gender sensitive interventions for promoting well-being and health systems strengthening. The findings from these papers collectively show how gender intersects with other axes of inequity within specific contexts to shape experiences of health and health seeking within households, communities and health systems; illustrate how gender power relations affect access to important resources; and demonstrate that gender norms, poverty and patriarchy interplay to limit women’s choices and chances both within household interactions and within the health sector. Health systems researchers have a responsibility to promote the incorporation of gender analyses into their studies in order to inform more strategic, effective and equitable health systems interventions, programmes, and policies. Responding to gender inequitable systems, institutions, and services in this sector requires an ‘all hands-on deck’ approach. We cannot claim to take a ‘people-centred approach’ to health systems if the status quo continues.
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    Leaving no one behind: lessons on rebuilding health systems in conflict and crisis-affected states
    (BMJ Glob Health, 2017) Martineau, Tim; McPake, Barbara; Theobald, Sally; Raven, Joanna; Ensor, Tim; Fustukian, Suzanne; Ssengooba, Freddie; Chirwa, Yotamu; Vong, Sreytouch; Wurie, Haja; Hooton, Nick; Witter, Sophie
    Conflict and fragility are increasing in many areas of the world. This context has been referred to as the ‘new normal’ and affects a billion people. Fragile and conflict-affected states have the worst health indicators and the weakest health systems. This presents a major challenge to achieving universal health coverage. The evidence base for strengthening health systems in these contexts is very weak and hampered by limited research capacity, challenges relating to insecurity and apparent low prioritisation of this area of research by funders. This article reports on findings from a multicountry consortium examining health systems rebuilding post conflict/crisis in Sierra Leone, Zimbabwe, northern Uganda and Cambodia. Across the ReBUILD consortium’s interdisciplinary research programme, three cross-cutting themes have emerged through our analytic process: communities, human resources for health and institutions. Understanding the impact of conflict/crisis on the intersecting inequalities faced by households and communities is essential for developing responsive health policies. Health workers demonstrate resilience in conflict/crisis, yet need to be supported post conflict/crisis with appropriate policies related to deployment and incentives that ensure a fair balance across sectors and geographical distribution.
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    Using life histories to explore gendered experiences of conflict in Gulu District, northern Uganda: Implications for post-conflict health reconstruction
    (South African Review of Sociology, 2016) Ssali, Sarah N.; Theobald, Sally
    The dearth of knowledge about what life was like for different women and men, communities and institutions during conflict has caused many post-conflict developers to undertake reconstruction using standardized models that may not always reflect the realities of the affected populations. There is a need to engage with and understand the life experiences, transformations and social concerns of people affected by conflict before, during and after the conflict in order to develop appropriate and context embedded post-conflict reconstruction strategies. This article discusses how life histories were deployed to explore how the 20 year conflict in northern Uganda transformed people’s lives. It presents how 47 men and women lived, experienced and remembered the war in northern Uganda, and the implications for health care reconstruction