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Increasing health system synergies in low-income settings

Lessons learned from a qualitative case study of Rwanda

Bibliographic Data

ID15540137
AuthorsMartin Rudasingwa (University Hospital Heidelberg, corresponding author), Andreas Jahn (0000-0001-8181-9795, Heidelberg University), Anne-Marie Uwitonze (University of Rwanda), Lisa Hennig (0000-0001-6982-4655, University Hospital Heidelberg)
Year2022
Volume17
Issue12
Pages3303-3321
Publication date2022-10-04
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueGlobal Public Health (JOURNAL)
Journal identifiersISSN: 1744-1692 • E-ISSN: 1744-1706
PublisherTaylor & Francis (PUBLISHER • GB)
DOI10.1080/17441692.2022.2129726
PMID36194788
OpenAlexW4301185073
LanguageEN
Citations received2
References cited34

Building synergies is seen as an effective strategy to address and decrease existing fragmentation in health systems of low-and middle-income countries (LMICs). To that end, different programmes, such as the Sector Wide Approach, have been adopted to increase health system synergies. Despite these efforts, fragmentation remains an enduring problem, hampering health system performance in LMICs. This study is part of the Lancet Commission on synergies between Universal Health Coverage, Health Security, and Health Promotion; we aimed to document synergising strategies adopted by Rwanda. Data for this paper came from a qualitative study including in-depth interviews of 15 key informants and a document review. A thematic analysis embracing deductive and inductive approaches was used to analyse the data. We found that Rwanda adopted three main strategies to increase health system synergies: (1) alignment of health programmes with national health policies and strategies, (2) increased coordination across national health institutions, and (3) effective monitoring and evaluation frameworks. Achieving synergies in a low-resource country is challenging but not impossible. To meet the target of global health agendas such as the Sustainable Development Goals and the prevention of future global pandemics, efforts to increase health system synergies in LMICs need to be strengthened

Business · Economic growth · Economics · Global health · Health care · Health promotion · Political science · Public relations · Qualitative research · Sociology · Thematic analysis · Global Maternal and Child Health · Global Public Health Policies and Epidemiology · Healthcare Systems and Reforms · Health Policy

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Unique citing works2
Citations per year2
Citation span2025 - 2026 (2)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 2
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