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Analysing the implementation of Health financing reform in South Africa and Zambia

Objective

* Strengthen the implementation of critical financing reforms in South Africa and Zambia, through analysis of these countries' experience.
* Through comparative analyses of the two countries, deepen international understanding of the factors mediating the effective implementation of just and rational financing reforms, and so generate appropriate policy recommendations.
* Develop generalisable approaches to monitoring the implementation of health financing reforms.
* Develop capacity in South African and Zambian Departments/Ministries of Health and university-based research units to evaluate health financing reform.
* Foster close long-term collaboration between South African, Zambian and European health research institutions.
Expected Outcome

* The publication of detailed, country-specific and comparative data, analyses and recommendations.
* The publication of the framework used in monitoring the development and implementation of the reforms in focus, with the aim of drawing out appropriate lessons for other low and middle income countries and demonstrating the value of a comprehensive research approach.
* The involvement of Departments/Ministries of Health in the research process and in workshops which analyse findings and develop recommendations, and the integration of the activities of the research partners in a balanced way to create a cohesive research team.
* The development of new research proposals which include the collaborating partners and researchers from an historically black university in South Africa.
Phase 1 will last one year and will be a retrospective evaluation of the evolution of the reforms of focus and of the factors influencing policy development and implementation. It will also develop a framework for the prospective monitoring and evaluation of reform in Phase II, which will: facilitate understanding the linkages between reforms; specify the explicit, societal goals of reform (such as equity, access, efficiency and sustainability) and identify indications with which to measure the extent to which reforms achieve these goals; identify the critical factors that affect reforms through their influence on the processes of policy development and implementation; and identify mechanisms to maximise the objectivity of the research despite the involvement of the researchers in the process of policy development and of government planners in the evaluation process.

The methods used in Phase I will include: analysis of international literature, analysis of existing country-specific documentation; key informant interviews; focus group discussions; and facility-based record reviews.

Phase II will be a prospective evaluation over two years of the processes of implementation and the effectiveness of the reforms in achieving their goals, using the framework developed in Phase I. The methods used will include: utilisation of ongoing data efforts undertaken outside the study; sample facility studies/surveys; action research studies; and qualitative surveys.

Funding Scheme

CSC - Cost-sharing contracts

Coordinator

University of the Witwatersrand
Address

2000 Johannesburg
South Africa

Participants (4)

London School of Hygiene and TropicalMedicine
United Kingdom
Address
Keppel Street
WC1E 7HT London
THE SWEDISH INSTITUTE FOR HEALTH ECONOMICS
Sweden
Address
2,Raabygatan 2
220 02 Lund
UNIVERSITY OF CAPE TOWN
South Africa
Address
.,Medical School, Anzio Road Observatory
7925 Observatory, Cape Town
University of Zambia
Zambia
Address

50110 Lusaka