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The focus of this report is on the research needed to provide wider access and universal coverage to essential services, and how to create the environment in which this research can be carried out.
The report poses questions about how to choose the health services and coverage needed in each setting in order to protect and improve health and well-being, as well as how to measure progress towards the coverage of these services. As such, it is a key document to support MamaYe in providing solid evidence to support advocacy and accountability to improve health.
The document calls for a need to support the development of capacity at local level to provide local answers about how to address universal coverage. A set of actions are proposed by which different actors can support the research that is needed to achieve universal coverage.
Case studies of how research systems have been strengthened in countries are presented and examples of how research has addressed major questions about achieving universal coverage are presented. These include studies that have influenced policy and health outcomes.
The report includes some information on MamaYe countries:
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- In a survey among 26 countries on the status of health systems research,Ghana’s exceptional research capacity is recognised (p.97).
- A needs assessment of 14 West Africa countries conducted by Research for Health Africa identified Sierra Leone, along with four other West African countries, as most in need of support in strengthening health research systems (p.108).
- The Tanzanian Commission for Science and Technology uses a platform provided by the health research web as a platform. This platform uses an editable wiki-type format that provides data, tables and graphs for monitoring and evaluating research investments at national or institutional level and can be adapted to individual organisations (p.112)
- Malawi was the first country to propose the use of conditional cash transfers cash payments made in return for using health services. The report describes how research from a multi-country study found that this intervention encourages the use of these services and lead to better health outcomes (p.64).
Findings from research that have led to initiatives supporting universal coverage include:
- A multi-country study, including Tanzania, found that task-shifting from health workers with longer duration of training (doctors, clinical officers) to those with a shorter period (nurses, midwives and nurse assistants) did not compromise the quality of healthcare provided as part of integrated management of childhood illnesses (p. 75).
- Results from an experimental trial among four countries including Ethiopia, provide evidence to support development of regionally recommended universal access to treatment for visceral leishmanisis.
- A multi-country study by the London School of Hygiene and Tropical Medicine including
margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Tanzania, found that simple diagnostics and same-day-treatment for syphilis among prenatal and high risk populations was effective and feasible, with no need for new infrastructure (p. 109). The intervention led to reduced prevalence of syphilis and the risk of HIV infection, and the government responded rapidly with appropriate policy changes.