Neil Spicer
Biographic Data
| ID | 159181 |
|---|---|
| NAME | Neil Spicer |
| GIVEN NAMES | Neil |
| FAMILY NAME | Spicer |
| SIGNATURE | SPICER N |
| AFFILIATIONS | London School of Hygiene & Tropical Medicine |
| ORCID | 0000-0003-3451-8003 |
| VERIFIED | Yes |
| TOTAL WORKS | 32 |
| TOTAL CITATIONS | 131 |
| AUTHOR COUNT | 32 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2005 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 6 |
Implementing effective cataract surgical coverage
Introduction The WHO has set a 2030 target to raise effective cataract surgical coverage (eCSC) by 30 percentage points in every country, requiring gains in surgical access and quality. Despite this mandate, evidence on how low- and middle-income health systems are implementing eCSC remains limited. Methods We conducted a qualitative comparative case study in Kenya and Nepal. 20 interviews were held with senior stakeholders from government, non-g…
Mixed methods
Exploring a One Health approach to sustainability with international One Health and Global Health Security experts – differences, similarities and trade-offs between sectors
Sustainability in global health remains inconsistently defined and operationalised across human, animal, and environmental health sectors. As the One Health approach gains global traction—particularly in addressing complex, ‘wicked’ health problems such as pandemics, antimicrobial resistance, and ecosystem degradation—there is a growing need for shared conceptualisations of sustainability to support cross-sectoral collaboration and ultimately, lo…
Integrating eye health into a child health policy in Tanzania
Global consensus has shifted to focus on how children can be supported to not only ‘survive’ but to ‘thrive’. Blindness and visual loss in early childhood undermine a child’s ability to thrive, affecting psychomotor, cognitive, and social development leading to life-long consequences for educational attainment, employment, economic and social status, and wellbeing. Despite this, eye health for children under the age of 5 years has been neglected,…
Learning from Ethiopia’s success in reducing maternal and neonatal mortality through a health systems lens
BACKGROUND: This study aimed to enhance insights into the key characteristics of maternal and neonatal mortality declines in Ethiopia, conducted as part of a seven-country study on Maternal and Newborn Health (MNH) Exemplars. METHODS: We synthesised key indicators for 2000, 2010 and 2020 and contextualised those with typical country values in a global five-phase model for a maternal, stillbirth and neonatal mortality transition. We reviewed healt…
National health governance, science and the media
The COVID-19 pandemic is an unprecedented global crisis in which governments had to act in a situation of rapid change and substantial uncertainty. The governments of Germany, Sweden and the UK have taken different paths allowing learning for future pandemic preparedness. To help inform discussions on preparedness, inspired by resilience frameworks, this paper reviews governance structures, and the role of science and the media in the COVID-19 re…
A seamless transition’
Health interventions introduced as part of donor-funded projects need careful planning if they are to survive when donor funding ends. In northeast Nigeria, the Gombe State Primary Health Care Development Agency and implementing partners recognized this when introducing a Village Health Worker (VHW) Scheme in 2016. VHWs are a new cadre of community health worker, providing maternal, newborn and child health-related messages, basic healthcare and …
What are the challenges for antibiotic stewardship at the community level? An analysis of the drivers of antibiotic provision by informal healthcare providers in rural India
In many low- and middle-income countries, providers without formal training are an important source of antibiotics, but may provide these inappropriately, contributing to the rising burden of drug resistant infections. Informal providers (IPs) who practise allopathic medicine are part of India's pluralistic health system legacy. They outnumber formal providers but operate in a policy environment of unclear legitimacy, creating unique challenges f…
‘It’s far too complicated’
What role can health policy and systems research play in supporting responses to Covid-19 that strengthen socially just health systems
To say that we live in turbulent times is a massive understatement. COVID-19 ruthlessly exposes the fault lines of health services and systems, and the responses put in place to prevent its spread or mitigate its effects may affect people more than the actual infection. The outbreak in Wuhan quickly grew to a pandemic that has affected countries and regions all over the world in many, and as of yet, little understood ways. This is a global infect…
‘The development sector is a graveyard of pilot projects!’ Six critical actions for externally funded implementers to foster scale-up of maternal and newborn health innovations in low and middle-incom…
BACKGROUND: Donors often fund projects that develop innovative practices in low and middle-income countries, hoping recipient governments will adopt and scale them within existing systems and programmes. Such innovations frequently end when project funding ends, limiting longer term potential in countries with weak health systems and pressing health needs. This paper aims to identify critical actions for externally funded project implementers to …
‘The stars seem aligned’
BACKGROUND: Donors commonly fund innovative interventions to improve health in the hope that governments of low and middle-income countries will scale-up those that are shown to be effective. Yet innovations can be slow to be adopted by country governments and implemented at scale. Our study explores this problem by identifying key contextual factors influencing scale-up of maternal and newborn health innovations in three low-income settings: Eth…
District decision-making for health in low-income settings
Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identifi…
Sexual rights but not the right to health? Lesbian and bisexual women in South Africa's National Strategic Plans on HIV and STIs
Synergies between securing sexual rights and the right to health have been pursued where there are clear public health gains to be made, such as lowering incidence of HIV and other sexually transmitted infections (STI). South Africa's 1996 Constitution outlawed discrimination on the basis of sexual orientation and promoted the right to health. This qualitative health policy analysis sought to understand why and how interventions to improve sexual…
After the Global Fund
Peru has received around $70 million from Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund). Recent economic growth resulted in grant ineligibility, enabling greater government funding, yet doubts remain concerning programme continuity. This study examines the transition from Global Fund support to increasing national HIV/AIDS funding in Peru (2004-2012) by analysing actor roles, motivations and effects on policies, identifying re…
Scaling-up is a craft not a science
Donors and other development partners commonly introduce innovative practices and technologies to improve health in low and middle income countries. Yet many innovations that are effective in improving health and survival are slow to be translated into policy and implemented at scale. Understanding the factors influencing scale-up is important. We conducted a qualitative study involving 150 semi-structured interviews with government, development …
Measuring governance at health facility level
BACKGROUND: Governance has been cited as a key determinant of economic growth, social advancement and overall development. Achievement of millennium development goals is partly dependant on governance practices. In 2007, Health Systems 20/20 conducted an Internet-based survey on the practice of good governance. The survey posed a set of good practices related to health governance and asked respondents to indicate whether their experience confirme…
Institutional Solutions to the Asymmetric Information Problem in Health and Development Services for the Poor
The world’s poorest pay for professional services and thus are in a “market,” whether the services are provided in the public or private sectors. The associated problems of unequal information are particularly acute in undergoverned countries, where state regulation is weak. We systematically review the evidence on solutions to these problems in a variety of professions. Payments by clients are more likely to have a positive effect on quality if …
Has Global Fund support for civil society advocacy in the Former Soviet Union established meaningful engagement or 'a lot of jabber about nothing
Although civil society advocacy for health issues such as HIV transmission through injecting drug use is higher on the global health agenda than previously, its impact on national policy reform has been limited. In this paper we seek to understand why this is the case through an examination of civil society advocacy efforts to reform HIV/AIDS and drugs-related policies and their implementation in three former Soviet Union countries. In-depth semi…
Kyrgyzstan
As in other countries of Central Asia, HIV infections in Kyrgyzstan have increased steeply in recent years, driven by factors such as the sharing of drug paraphernalia among injecting drug users, sex work and other risky sex behaviours, prison settings and infections acquired in hospitals. In contrast to its neighbours, Kyrgyzstan has long been considered a regional pioneer in its response to the HIV/AIDS epidemic, displaying political will and s…
The International Health Partnership Plus
BACKGROUND: The Paris Declaration on Aid Effectiveness, which provides an international agreement on how to deliver aid, has recently been reviewed by the Organization for Economic Co-operation and Development (OECD). Health sector aid effectiveness is important, given the volume of financial aid and the number of mechanisms through which health assistance is provided. Recognizing this, the international community created the International Health…
Best Resources on … The Current Effects of Global Health Initiatives on Country Health Systems
This article outlines ten of the best resources that focus on the current effects of global health initiatives (Global Fund to Fight AIDS Tuberculosis and Malaria PEPFAR MAP GAVI Alliance) on country health systems. It lists and describes the usefulness of the ten resources which include: The Systems-Wide Effects of the Global Fund to Fight AIDS Tuberculosis and Malaria: A Conceptual Framework; Global health initiatives and public health policy; …
'It's risky to walk in the city with syringes'
BACKGROUND: Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policym…
Circus monkeys or change agents? Civil society advocacy for HIV/Aids in adverse policy environments
National and subnational HIV/Aids coordination
BACKGROUND: A coordinated response to HIV/AIDS remains one of the 'grand challenges' facing policymakers today. Global health initiatives (GHIs) have the potential both to facilitate and exacerbate coordination at the national and subnational level. Evidence of the effects of GHIs on coordination is beginning to emerge but has hitherto been limited to single-country studies and broad-brush reviews. To date, no study has provided a focused synthes…
Places of Exclusion and Inclusion
This paper explores asylum-seekers' and refugees' experiences of place, social exclusion and social networks, based on a qualitative sociological study. It examines interviewees' constructions of neighbourhoods as excluding or including places and compares and contrasts parents' and children's accounts. Interviewees perceived social inclusion as a number of place-specific factors, including security, access to inclusive local resources and servic…
Preventing Social Exclusion of Refugee and Asylum Seeking Children
Research demonstrates the important role of refugees and asylum seekers' social networks in providing both the practical and emotional support necessary to mitigate social exclusion and promote integration within receiving societies. Based on research conducted by the National Evaluation of the Children's Fund, we highlight the barriers to network building for refugee and asylum seeking children and families, and the ways in which Children's Fund…
Circus monkeys or change agents? Civil society advocacy for HIV/Aids in adverse policy environments
Institutional Solutions to the Asymmetric Information Problem in Health and Development Services for the Poor
The world’s poorest pay for professional services and thus are in a “market,” whether the services are provided in the public or private sectors. The associated problems of unequal information are particularly acute in undergoverned countries, where state regulation is weak. We systematically review the evidence on solutions to these problems in a variety of professions. Payments by clients are more likely to have a positive effect on quality if …
What role can health policy and systems research play in supporting responses to Covid-19 that strengthen socially just health systems
To say that we live in turbulent times is a massive understatement. COVID-19 ruthlessly exposes the fault lines of health services and systems, and the responses put in place to prevent its spread or mitigate its effects may affect people more than the actual infection. The outbreak in Wuhan quickly grew to a pandemic that has affected countries and regions all over the world in many, and as of yet, little understood ways. This is a global infect…
Has Global Fund support for civil society advocacy in the Former Soviet Union established meaningful engagement or 'a lot of jabber about nothing
Although civil society advocacy for health issues such as HIV transmission through injecting drug use is higher on the global health agenda than previously, its impact on national policy reform has been limited. In this paper we seek to understand why this is the case through an examination of civil society advocacy efforts to reform HIV/AIDS and drugs-related policies and their implementation in three former Soviet Union countries. In-depth semi…
Scaling-up is a craft not a science
Donors and other development partners commonly introduce innovative practices and technologies to improve health in low and middle income countries. Yet many innovations that are effective in improving health and survival are slow to be translated into policy and implemented at scale. Understanding the factors influencing scale-up is important. We conducted a qualitative study involving 150 semi-structured interviews with government, development …
Developing Children and Young People's Participation in Strategic Processes
The extent of children's and young people's participation activities has increased considerably among statutory, voluntary and community sector organisations across the UK in recent years. The Children's Fund, a major government initiative launched in 2000, represents a systematic drive towards promoting children and young people's participation in planning, implementing and evaluating preventative services within all 149 local authority areas in…
District decision-making for health in low-income settings
Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identifi…
Evaluating Complex, Area-Based Initiatives in a Context of Change
Complex, area-based initiatives are a widely adopted policy response to problems of health inequalities and social exclusion in industrialized countries such as the UK and the US.This article explores the problems of evaluating such initiatives in a context of rapid national and local policy change by drawing on the Children's Fund, a UK government initiative that established local partnerships in each English local authority to promote children'…
Sexual rights but not the right to health? Lesbian and bisexual women in South Africa's National Strategic Plans on HIV and STIs
Synergies between securing sexual rights and the right to health have been pursued where there are clear public health gains to be made, such as lowering incidence of HIV and other sexually transmitted infections (STI). South Africa's 1996 Constitution outlawed discrimination on the basis of sexual orientation and promoted the right to health. This qualitative health policy analysis sought to understand why and how interventions to improve sexual…
Is Participation Prevention
This article explores the relationships between two key concepts that have defined recent social policy initiatives for children in the UK: participation and prevention from social exclusion. Drawing on the Children's Fund initiative as an example, the article traces the diverse and sometimes contradictory discourses of childhood and social inclusion/exclusion in stakeholders' differing rationales for supporting children's participation and preve…
Sedentarization and children's health
What are the challenges for antibiotic stewardship at the community level? An analysis of the drivers of antibiotic provision by informal healthcare providers in rural India
In many low- and middle-income countries, providers without formal training are an important source of antibiotics, but may provide these inappropriately, contributing to the rising burden of drug resistant infections. Informal providers (IPs) who practise allopathic medicine are part of India's pluralistic health system legacy. They outnumber formal providers but operate in a policy environment of unclear legitimacy, creating unique challenges f…
Kyrgyzstan
As in other countries of Central Asia, HIV infections in Kyrgyzstan have increased steeply in recent years, driven by factors such as the sharing of drug paraphernalia among injecting drug users, sex work and other risky sex behaviours, prison settings and infections acquired in hospitals. In contrast to its neighbours, Kyrgyzstan has long been considered a regional pioneer in its response to the HIV/AIDS epidemic, displaying political will and s…
Sedentarization and children's health
Developing Children and Young People's Participation in Strategic Processes
The extent of children's and young people's participation activities has increased considerably among statutory, voluntary and community sector organisations across the UK in recent years. The Children's Fund, a major government initiative launched in 2000, represents a systematic drive towards promoting children and young people's participation in planning, implementing and evaluating preventative services within all 149 local authority areas in…
Preventing Social Exclusion of Refugee and Asylum Seeking Children
Research demonstrates the important role of refugees and asylum seekers' social networks in providing both the practical and emotional support necessary to mitigate social exclusion and promote integration within receiving societies. Based on research conducted by the National Evaluation of the Children's Fund, we highlight the barriers to network building for refugee and asylum seeking children and families, and the ways in which Children's Fund…
Evaluating Complex, Area-Based Initiatives in a Context of Change
Complex, area-based initiatives are a widely adopted policy response to problems of health inequalities and social exclusion in industrialized countries such as the UK and the US.This article explores the problems of evaluating such initiatives in a context of rapid national and local policy change by drawing on the Children's Fund, a UK government initiative that established local partnerships in each English local authority to promote children'…
Places of Exclusion and Inclusion
This paper explores asylum-seekers' and refugees' experiences of place, social exclusion and social networks, based on a qualitative sociological study. It examines interviewees' constructions of neighbourhoods as excluding or including places and compares and contrasts parents' and children's accounts. Interviewees perceived social inclusion as a number of place-specific factors, including security, access to inclusive local resources and servic…
Is Participation Prevention
This article explores the relationships between two key concepts that have defined recent social policy initiatives for children in the UK: participation and prevention from social exclusion. Drawing on the Children's Fund initiative as an example, the article traces the diverse and sometimes contradictory discourses of childhood and social inclusion/exclusion in stakeholders' differing rationales for supporting children's participation and preve…
The effects of global health initiatives on country health systems
This paper reviews country-level evidence about the impact of global health initiatives (GHIs), which have had profound effects on recipient country health systems in middle and low income countries. We have selected three initiatives that account for an estimated two-thirds of external funding earmarked for HIV/AIDS control in resource-poor countries: the Global Fund to Fight AIDS, TB and Malaria, the World Bank Multi-country AIDS Program (MAP) …
National and subnational HIV/Aids coordination
BACKGROUND: A coordinated response to HIV/AIDS remains one of the 'grand challenges' facing policymakers today. Global health initiatives (GHIs) have the potential both to facilitate and exacerbate coordination at the national and subnational level. Evidence of the effects of GHIs on coordination is beginning to emerge but has hitherto been limited to single-country studies and broad-brush reviews. To date, no study has provided a focused synthes…
'It's risky to walk in the city with syringes'
BACKGROUND: Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policym…
Circus monkeys or change agents? Civil society advocacy for HIV/Aids in adverse policy environments
The International Health Partnership Plus
BACKGROUND: The Paris Declaration on Aid Effectiveness, which provides an international agreement on how to deliver aid, has recently been reviewed by the Organization for Economic Co-operation and Development (OECD). Health sector aid effectiveness is important, given the volume of financial aid and the number of mechanisms through which health assistance is provided. Recognizing this, the international community created the International Health…
Best Resources on … The Current Effects of Global Health Initiatives on Country Health Systems
This article outlines ten of the best resources that focus on the current effects of global health initiatives (Global Fund to Fight AIDS Tuberculosis and Malaria PEPFAR MAP GAVI Alliance) on country health systems. It lists and describes the usefulness of the ten resources which include: The Systems-Wide Effects of the Global Fund to Fight AIDS Tuberculosis and Malaria: A Conceptual Framework; Global health initiatives and public health policy; …
Measuring governance at health facility level
BACKGROUND: Governance has been cited as a key determinant of economic growth, social advancement and overall development. Achievement of millennium development goals is partly dependant on governance practices. In 2007, Health Systems 20/20 conducted an Internet-based survey on the practice of good governance. The survey posed a set of good practices related to health governance and asked respondents to indicate whether their experience confirme…
Institutional Solutions to the Asymmetric Information Problem in Health and Development Services for the Poor
The world’s poorest pay for professional services and thus are in a “market,” whether the services are provided in the public or private sectors. The associated problems of unequal information are particularly acute in undergoverned countries, where state regulation is weak. We systematically review the evidence on solutions to these problems in a variety of professions. Payments by clients are more likely to have a positive effect on quality if …
Has Global Fund support for civil society advocacy in the Former Soviet Union established meaningful engagement or 'a lot of jabber about nothing
Although civil society advocacy for health issues such as HIV transmission through injecting drug use is higher on the global health agenda than previously, its impact on national policy reform has been limited. In this paper we seek to understand why this is the case through an examination of civil society advocacy efforts to reform HIV/AIDS and drugs-related policies and their implementation in three former Soviet Union countries. In-depth semi…
Kyrgyzstan
As in other countries of Central Asia, HIV infections in Kyrgyzstan have increased steeply in recent years, driven by factors such as the sharing of drug paraphernalia among injecting drug users, sex work and other risky sex behaviours, prison settings and infections acquired in hospitals. In contrast to its neighbours, Kyrgyzstan has long been considered a regional pioneer in its response to the HIV/AIDS epidemic, displaying political will and s…
After the Global Fund
Peru has received around $70 million from Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund). Recent economic growth resulted in grant ineligibility, enabling greater government funding, yet doubts remain concerning programme continuity. This study examines the transition from Global Fund support to increasing national HIV/AIDS funding in Peru (2004-2012) by analysing actor roles, motivations and effects on policies, identifying re…
Scaling-up is a craft not a science
Donors and other development partners commonly introduce innovative practices and technologies to improve health in low and middle income countries. Yet many innovations that are effective in improving health and survival are slow to be translated into policy and implemented at scale. Understanding the factors influencing scale-up is important. We conducted a qualitative study involving 150 semi-structured interviews with government, development …
‘The stars seem aligned’
BACKGROUND: Donors commonly fund innovative interventions to improve health in the hope that governments of low and middle-income countries will scale-up those that are shown to be effective. Yet innovations can be slow to be adopted by country governments and implemented at scale. Our study explores this problem by identifying key contextual factors influencing scale-up of maternal and newborn health innovations in three low-income settings: Eth…
District decision-making for health in low-income settings
Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identifi…
Sexual rights but not the right to health? Lesbian and bisexual women in South Africa's National Strategic Plans on HIV and STIs
Synergies between securing sexual rights and the right to health have been pursued where there are clear public health gains to be made, such as lowering incidence of HIV and other sexually transmitted infections (STI). South Africa's 1996 Constitution outlawed discrimination on the basis of sexual orientation and promoted the right to health. This qualitative health policy analysis sought to understand why and how interventions to improve sexual…
‘The development sector is a graveyard of pilot projects!’ Six critical actions for externally funded implementers to foster scale-up of maternal and newborn health innovations in low and middle-incom…
BACKGROUND: Donors often fund projects that develop innovative practices in low and middle-income countries, hoping recipient governments will adopt and scale them within existing systems and programmes. Such innovations frequently end when project funding ends, limiting longer term potential in countries with weak health systems and pressing health needs. This paper aims to identify critical actions for externally funded project implementers to …
‘It’s far too complicated’
What role can health policy and systems research play in supporting responses to Covid-19 that strengthen socially just health systems
To say that we live in turbulent times is a massive understatement. COVID-19 ruthlessly exposes the fault lines of health services and systems, and the responses put in place to prevent its spread or mitigate its effects may affect people more than the actual infection. The outbreak in Wuhan quickly grew to a pandemic that has affected countries and regions all over the world in many, and as of yet, little understood ways. This is a global infect…
National health governance, science and the media
The COVID-19 pandemic is an unprecedented global crisis in which governments had to act in a situation of rapid change and substantial uncertainty. The governments of Germany, Sweden and the UK have taken different paths allowing learning for future pandemic preparedness. To help inform discussions on preparedness, inspired by resilience frameworks, this paper reviews governance structures, and the role of science and the media in the COVID-19 re…
Political science (26 works) · Economic growth (24 works) · Economics (24 works) · Medicine (20 works) · Business (15 works) · Global Maternal and Child Health (15 works) · Public health (14 works) · Public relations (14 works) · Nursing (12 works) · Sociology (12 works)