Country perspectives on improving technical assistance in the health sector

Gates Open Research

article

Natasha Kanagat¹  Jeanne Chauffour¹  Jean-Fidèle Ilunga²  Sylvain Yuma Ramazani²  John J.P. Ovuoraye Ajiwohwodoma³  Salma Ibrahim Anas-Kolo³  Oleka Maryjane⁴  Nkeiru Onuekwusi⁵  Toto Ezombe²  James Dominion³  Joseph Sunday⁶  Joseph Kasongo²  Gavial Ngambwa²  Christy Asala⁷  Célestin Nsibu¹  Abimbola Williams¹  Melanie Wendland⁸  Emilia Klimiuk⁸  Anne LaFond¹  Nosa Orobaton⁹  Dyness Kasungami¹ 

[1] JSI Research & Training Institute, Inc.;Ministry of Health of the Democratic Republic of the Congo;Federal Ministry of Health;National Primary Health Care Development Agency;Independent Consultant;Kaduna State Ministry of Health;White Ribbon Alliance;Sonder Collective;Bill & Melinda Gates Foundation

关键词: TA;    technical assistance;    MNCH;    maternal health;    neonatal health;    child health;    health systems strengthening;    HCD;    re-design;    reimagine;    re-imagine;    redesign;    human-centered design;    co-creation;    DRC;    Nigeria;    Democratic Republic of the Congo;    Democratic Republic of Congo;    maternal and child health;   

DOI  :  10.12688/gatesopenres.13248.1

学科分类：电子与电气工程

来源: American Journal Of Pharmtech Research

【 摘 要 】

Background: This paper presents learnings from the Re-Imagining Technical Assistance for Maternal, Neonatal, and Child Health and Health Systems Strengthening (RTA) project implemented in the Democratic Republic of the Congo and Nigeria from April 2018 to September 2020 by JSI Research & Training Institute, Inc. and Sonder Collective and managed by the Child Health Task Force. The first of RTA’s two phases involved multiple design research activities, such as human-centered design and co-creation, while the second phase focused on secondary analysis of interviews and reports from the design research. This paper explores the limitations of current technical assistance (TA) approaches and maps opportunities to improve how TA is planned and delivered in the health sector. Methods: We analyzed project reports and 68 interviews with TA funders, providers, and consumers to explore in greater detail their perspectives on TA, its characteristics and drawbacks as well as opportunities for improvement. We used qualitative content analysis techniques for this study.   Results: The issues surrounding TA included the focus on donor-driven agendas over country priorities, poor accountability between and within TA actors, inadequate skill transfer from TA providers to government TA consumers, an emphasis on quick fixes and short-term thinking, and inadequate governance mechanisms to oversee and manage TA. Consequently, health systems do not achieve the highest levels of resilience and autonomy. Conclusions: Participants in project workshops and interviews called for a transformation in TA centered on a redistribution of power enabling governments to establish their health agendas in keeping with the issues that are of greatest importance to them, followed by collaboration with donors to develop TA interventions. Recommended improvements to the TA landscape in this paper include nine critical shifts, four domains of change, and 20 new guiding principles.

【 授权许可】

CC BY