Health sector fragmentation
Three examples from Sierra Leone
Bibliographic Data
| ID | 19534189 |
|---|---|
| Authors | A Barr (0000-0002-1241-9162, Simon Fraser University), Lauryn Garrett (0000-0002-1541-4762, Simon Fraser University), Rainer Martens (0000-0002-2416-2309, London School of Hygiene & Tropical Medicine), Robert Marten, Sowmya Kadandale |
| Year | 2019 |
| Volume | 15 |
| Issue | 1 |
| Pages | 8-8 |
| Publication date | 2019-12-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Globalization and Health (JOURNAL) |
| Journal identifiers | ISSN: 1744-8603 • E-ISSN: 1744-8603 |
| Publisher | Springer Science and Business Media LLC (PUBLISHER) |
| DOI | 10.1186/s12992-018-0447-5 |
| PMID | 30670026 |
| OpenAlex | W2911987285 |
| Language | EN |
| Citations received | 19 |
| References cited | 21 |
BACKGROUND: Fragmentation across governance structures, funding, and external actor engagement in Sierra Leone continues to challenge the efficiency and coherence of health sector activities and impedes sustained health system strengthening. Three examples are discussed to highlight the extent, causes, and impacts of health sector fragmentation in Sierra Leone: the community health worker programme, national medical supply chain, and service level agreements. RESULTS: In these examples we discuss factors contributing to fragmentation, the impact on efficiency of systems and sustainability of interventions, and persistent barriers to achieving sustainable improvements in health system performance. Prolonged external dependence and a proliferation of partner and donor involvement tending towards vertical programming and funding have contributed to this fragmentation. CONCLUSION: Alignment of policy and planning initiatives, investment in proactive (to reduce need for reactive) policy and plan development, strengthened partnerships, and strengthened governance and accountability mechanisms offer opportunities for greater health sector integration
Biology · Geography · Health services research · Political science · Public health · Sierra leone · Social policy · Socioeconomics · Sociology · Global Health and Surgery · Global Maternal and Child Health · Healthcare Systems and Reforms · Law · Medicine · Nursing · Health Policy
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| Unique citing works | 19 |
|---|---|
| Citations per year | 2,38 |
| Citation span | 2018 - 2026 (9) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 15 |