Timothy Powell-Jackson
Datos Biográficos
| ID | 1235684 |
|---|---|
| NOMBRE | Timothy Powell-Jackson |
| NOMBRES | Timothy |
| APELLIDO | Powell-Jackson |
| FIRMA | POWELL-JACKSON T |
| AFILIACIONES | London School of Hygiene & Tropical Medicine |
| ORCID | 0000-0002-6082-3805 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 33 |
| TOTAL DE CITAS | 25 |
| TOTAL COMO AUTOR | 33 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2007 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 3 |
Happiness and life satisfaction
Are hospital management practices associated with enhanced quality of care for small and sick newborns? A nationwide cross-sectional study using linked inpatient admission records in Malawi
Background: Improved quality of care is fundamental for reducing patient mortality and building sustainable health systems. Currently, there is a lack of research on the role of hospital management in improving the quality of care and health outcomes, particularly in low-income settings. Methods: We examined associations between hospital management practices and neonatal quality of care in Malawi. We adapted the World Management Survey tool to me…
What is the relationship between hospital management practices and quality of care? A systematic review of the global evidence
There is a widely held view that good management improves organizational performance. However, hospitals are complex organizations, and the relationship between management practices and health service delivery is not straightforward. We conducted a global, systematic literature review of the quantitative evidence on the link between the adoption of management practices and quality of care in hospitals. We searched in PubMed, EMBASE, EconLit, Glob…
The impacts of removing pharmaceutical co-payments for chronic conditions at primary care level
The underutilization of primary care (PC) presents a substantial challenge in enhancing the people-centeredness, quality, and efficiency of health services for patients with chronic diseases. Pharmaceutical copayments have been considered a key barrier to patient access in low- and middle-income countries. It is unclear whether the removal of pharmaceutical copayment can lead to better care and management of chronic diseases. This study sought to…
Healthcare payor management practices are associated with health system performance and population health
Good management practice has long been seen as critical to improving the performance, quality, and efficiency of healthcare systems. Better hospital management practice has been shown to correlate with improved clinical quality and performance. However, the association between the management practices of healthcare payors, the performance of the healthcare systems they oversee, and the health of their managed populations, has not been explored qu…
Healthy competition? Market structure and the quality of clinical care given to standardised patients in Tanzania
The private health care sector in many low- and middle-income countries is rapidly expanding. Private sector advocates have long argued that market competition drives private providers to become more efficient and responsive to patients but empirical studies are limited to mostly high-income settings. We examine whether the number of competing health facilities in close proximity is associated with quality and prices, in a sample of 228 private f…
Inclusion of disability in primary healthcare facilities and socioeconomic inequity in Brazil
OBJECTIVE: To describe disability-related performance and inequality nationwide in Brazil, and the changes that took place between 2012 and 2019 after the introduction of Programme for Improving Primary Care Access and Quality (PMAQ). METHODS: We derived scores for disability-related care and accessibility of primary healthcare facilities from PMAQ indicators collected in round 1 (2011-2013), and round 3 (2015-2019). We assessed how scores change…
Understanding the municipal-level design and adaptation of pay-for-performance schemes across two states of Brazil
The design of complex health systems interventions, such as pay for performance (P4P), can be critical to determining such programmes’ success. In P4P programmes, the design of financial incentives is crucial in shaping how these programmes work. However, the design of such schemes is usually homogenous across providers within a given scheme. Consequently, there is a limited understanding of the strengths and weaknesses of P4P design elements fro…
Does pay-for-performance design matter? Evidence from Brazil
Pay-for-performance (P4P) schemes have been shown to have mixed effects on health care outcomes. A challenge in interpreting this evidence is that P4P is often considered a homogenous intervention, when in practice schemes vary widely in their design. Our study contributes to this literature by providing a detailed depiction of incentive design across municipalities within a national P4P scheme in Brazil [Primary Care Access and Quality (PMAQ)] a…
Measuring healthcare payor management practices in England
Good management practice in healthcare payors and providers is considered central to ensuring health systems respond to population needs, contain costs, and improve both quality and outcomes. However, the evidence to support this assertion is sparce. While a quantitative link between better management practice and improved patient outcomes has been demonstrated for healthcare providers, no such link has been identified for healthcare payors. The …
Determinants of government spending on primary healthcare
In 2018 global leaders renewed their political commitment to primary healthcare (PHC) ratifying the Declaration of Astana emphasising the importance of building a sustainable PHC system based on accessible and affordable delivery models strengthened by community empowerment. Yet, PHC often remains underfunded, of poor quality, unreliable and not accountable to users which further deprives PHC of funding. This paper analyses the determinants of PH…
Understanding why EmpaTeach did not reduce teachers’ use of violence in Nyarugusu Refugee Camp
EmpaTeach was the first intervention to address teacher violence to be tested in a humanitarian setting and the first to focus on reducing impulsive use of violence, but a cluster randomised trial found no evidence that the intervention was effective in reducing physical and emotional violence from teachers. We aimed to understand why. We conducted a quantitative process evaluation to describe the intervention implementation process (what was imp…
Management Practices and Quality of Care
We measure the adoption of management practices in over 220 private for-profit and non-profit health facilities in 64 districts across Tanzania and link these data to process quality-of-care metrics, assessed using undercover standardised patients and clinical observations. We find that better managed health facilities are more likely to provide correct treatment in accordance with national treatment guidelines, adhere to a checklist of essential…
The Lancet Global Health Commission on financing primary health care
The COVID-19 pandemic has brought the need for well-functioning primary health care (PHC) into sharp focus. PHC is the best platform for providing basic health interventions (including effective management of non-communicable diseases) and essential public health functions. PHC is widely recognised as a key component of all high-performing health systems and is an essential foundation of universal health coverage. PHC was famously set as a global…
School violence, depression symptoms, and school climate
Forcibly displaced children are at increased risk of violence and mental health disorders. In refugee contexts, schools are generally perceived as protective environments where children can build a sense of belonging and recover from trauma. Evidence shows that positive school climates can support student skills development and socio-emotional wellbeing and protect them against a host of adverse outcomes. However, schools are also places where ch…
Pay for performance in primary care
BACKGROUND: Evidence on the effect of pay-for-performance (P4P) schemes on provider performance is mixed in low-income and middle-income countries. Brazil introduced its first national-level P4P scheme in 2011 (PMAQ-Brazilian National Programme for Improving Primary Care Access and Quality). PMAQ is likely one of the largest P4P schemes in the world. We estimate the association between PMAQ and hospitalisations for ambulatory care sensitive condi…
How much healthcare is wasted? A cross-sectional study of outpatient overprovision in private-for-profit and faith-based health facilities in Tanzania
Overprovision—healthcare whose harm exceeds its benefit—is of increasing concern in low- and middle-income countries, where the growth of the private-for-profit sector may amplify incentives for providing unnecessary care, and achieving universal health coverage will require efficient resource use. Measurement of overprovision has conceptual and practical challenges. We present a framework to conceptualize and measure overprovision, comparing for…
Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities
In order to reach the ambitious stated goal of reaching Universal Health Coverage in Indonesia, priority should be given to redressing current inequalities in the quality of care
A future for the world's children? A WHO–Unicef–Lancet Commission
Despite dramatic improvements in survival, nutrition, and education over recent decades, today's children face an uncertain future. Climate change, ecological degradation, migrating populations, conflict, pervasive inequalities, and predatory commercial practices threaten the health and future of children in every country. In 2015, the world's countries agreed on the Sustainable Development Goals (SDGs), yet nearly 5 years later, few countries ha…
Effectiveness of primary care gatekeeping
INTRODUCTION: This paper evaluates the effectiveness of a gatekeeping pilot in shifting resources and patient visits from hospitals to primary care facilities under the Chinese New Rural Cooperative Medical Scheme. METHODS: We applied a difference-in-differences regression analysis using claims data from a pilot district in northern China. The study covered 200 685 enrollees in 17 townships in 2012 and followed-up the townships over 12 year-quart…
The household economic burden of non-communicable diseases in 18 countries
Background: Non-communicable diseases (NCDs) are the leading cause of death globally. In 2014, the United Nations committed to reducing premature mortality from NCDs, including by reducing the burden of healthcare costs. Since 2014, the Prospective Urban and Rural Epidemiology (PURE) Study has been collecting health expenditure data from households with NCDs in 18 countries. Methods: Using data from the PURE Study, we estimated risk of catastroph…
How to do (or not to do) … using the standardized patient method to measure clinical quality of care in LMIC health facilities
Standardized patients (SPs), i.e. mystery shoppers for healthcare providers, are increasingly used as a tool to measure quality of clinical care, particularly in low- and middle-income countries where medical record abstraction is unlikely to be feasible. The SP method allows care to be observed without the provider’s knowledge, removing concerns about the Hawthorne effect, and means that providers can be directly compared against each other. How…
Measuring management practices in India's district public health bureaucracy
Trials and tribulations
The randomized controlled trial is commonly used by both epidemiologists and economists to test the effectiveness of public health interventions. Yet we have noticed differences in practice between the two disciplines. In this article, we propose that there are some underlying differences between the disciplines in the way trials are used, how they are conducted and how results from trials are reported and disseminated. We hypothesize that eviden…
Cash transfers, maternal depression and emotional well-being
Maternal depression is an important public health concern. We investigated whether a national-scale initiative that provides cash transfers to women giving birth in government health facilities, the Janani Suraksha Yojana (JSY), reduced maternal depression in India's largest state, Uttar Pradesh. Using primary data on 1695 women collected in early 2015, our quasi-experimental design exploited the fact that some women did not receive the JSY cash …
Who benefits from free healthcare? Evidence from a randomized experiment in Ghana
Democracy and growth in divided societies
Cash transfers, maternal depression and emotional well-being
Maternal depression is an important public health concern. We investigated whether a national-scale initiative that provides cash transfers to women giving birth in government health facilities, the Janani Suraksha Yojana (JSY), reduced maternal depression in India's largest state, Uttar Pradesh. Using primary data on 1695 women collected in early 2015, our quasi-experimental design exploited the fact that some women did not receive the JSY cash …
Measuring management practices in India's district public health bureaucracy
Measuring healthcare payor management practices in England
Good management practice in healthcare payors and providers is considered central to ensuring health systems respond to population needs, contain costs, and improve both quality and outcomes. However, the evidence to support this assertion is sparce. While a quantitative link between better management practice and improved patient outcomes has been demonstrated for healthcare providers, no such link has been identified for healthcare payors. The …
A review of health resource tracking in developing countries
Timely, reliable and complete information on financial resources in the health sector is critical for sound policy making and planning, particularly in developing countries where resources are both scarce and unpredictable. Health resource tracking has a long history and has seen renewed interest more recently as pressure has mounted to improve accountability for the attainment of the health Millennium Development Goals. We review the methods use…
Democracy and growth in divided societies
Good Health at Low Cost 25 years on
A decade of improvements in equity of access to reproductive and maternal health services in Cambodia, 2000–2010
Cambodia has made impressive improvements in overall coverage of reproductive and maternal health services over the last decade, and also in the distribution of their use across wealth quintiles. A range of pro-poor health financing and supply-side policies as well as non-health factors may have contributed to these achievements. Further research will explore specific schemes qualitatively and quantitatively to assess their impact on equity and s…
Can we trust measures of healthcare utilization from household surveys
The findings raise methodological concerns about measures of healthcare utilization from household surveys, particularly in the evaluation of health financing interventions
Who benefits from free healthcare? Evidence from a randomized experiment in Ghana
Financial incentives in health
This paper studies the health effects of one of the world's largest demand-side financial incentive programmes--India's Janani Suraksha Yojana. Our difference-in-difference estimates exploit heterogeneity in the implementation of the financial incentive programme across districts. We find that cash incentives to women were associated with increased uptake of maternity services but there is no strong evidence that the JSY was associated with a red…
The indirect effects of subsidised healthcare in rural Ghana
Cash transfers, maternal depression and emotional well-being
Maternal depression is an important public health concern. We investigated whether a national-scale initiative that provides cash transfers to women giving birth in government health facilities, the Janani Suraksha Yojana (JSY), reduced maternal depression in India's largest state, Uttar Pradesh. Using primary data on 1695 women collected in early 2015, our quasi-experimental design exploited the fact that some women did not receive the JSY cash …
Trials and tribulations
The randomized controlled trial is commonly used by both epidemiologists and economists to test the effectiveness of public health interventions. Yet we have noticed differences in practice between the two disciplines. In this article, we propose that there are some underlying differences between the disciplines in the way trials are used, how they are conducted and how results from trials are reported and disseminated. We hypothesize that eviden…
How to do (or not to do) … using the standardized patient method to measure clinical quality of care in LMIC health facilities
Standardized patients (SPs), i.e. mystery shoppers for healthcare providers, are increasingly used as a tool to measure quality of clinical care, particularly in low- and middle-income countries where medical record abstraction is unlikely to be feasible. The SP method allows care to be observed without the provider’s knowledge, removing concerns about the Hawthorne effect, and means that providers can be directly compared against each other. How…
Measuring management practices in India's district public health bureaucracy
A future for the world's children? A WHO–Unicef–Lancet Commission
Despite dramatic improvements in survival, nutrition, and education over recent decades, today's children face an uncertain future. Climate change, ecological degradation, migrating populations, conflict, pervasive inequalities, and predatory commercial practices threaten the health and future of children in every country. In 2015, the world's countries agreed on the Sustainable Development Goals (SDGs), yet nearly 5 years later, few countries ha…
Effectiveness of primary care gatekeeping
INTRODUCTION: This paper evaluates the effectiveness of a gatekeeping pilot in shifting resources and patient visits from hospitals to primary care facilities under the Chinese New Rural Cooperative Medical Scheme. METHODS: We applied a difference-in-differences regression analysis using claims data from a pilot district in northern China. The study covered 200 685 enrollees in 17 townships in 2012 and followed-up the townships over 12 year-quart…
The household economic burden of non-communicable diseases in 18 countries
Background: Non-communicable diseases (NCDs) are the leading cause of death globally. In 2014, the United Nations committed to reducing premature mortality from NCDs, including by reducing the burden of healthcare costs. Since 2014, the Prospective Urban and Rural Epidemiology (PURE) Study has been collecting health expenditure data from households with NCDs in 18 countries. Methods: Using data from the PURE Study, we estimated risk of catastroph…
Pay for performance in primary care
BACKGROUND: Evidence on the effect of pay-for-performance (P4P) schemes on provider performance is mixed in low-income and middle-income countries. Brazil introduced its first national-level P4P scheme in 2011 (PMAQ-Brazilian National Programme for Improving Primary Care Access and Quality). PMAQ is likely one of the largest P4P schemes in the world. We estimate the association between PMAQ and hospitalisations for ambulatory care sensitive condi…
How much healthcare is wasted? A cross-sectional study of outpatient overprovision in private-for-profit and faith-based health facilities in Tanzania
Overprovision—healthcare whose harm exceeds its benefit—is of increasing concern in low- and middle-income countries, where the growth of the private-for-profit sector may amplify incentives for providing unnecessary care, and achieving universal health coverage will require efficient resource use. Measurement of overprovision has conceptual and practical challenges. We present a framework to conceptualize and measure overprovision, comparing for…
Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities
In order to reach the ambitious stated goal of reaching Universal Health Coverage in Indonesia, priority should be given to redressing current inequalities in the quality of care
The Lancet Global Health Commission on financing primary health care
The COVID-19 pandemic has brought the need for well-functioning primary health care (PHC) into sharp focus. PHC is the best platform for providing basic health interventions (including effective management of non-communicable diseases) and essential public health functions. PHC is widely recognised as a key component of all high-performing health systems and is an essential foundation of universal health coverage. PHC was famously set as a global…
School violence, depression symptoms, and school climate
Forcibly displaced children are at increased risk of violence and mental health disorders. In refugee contexts, schools are generally perceived as protective environments where children can build a sense of belonging and recover from trauma. Evidence shows that positive school climates can support student skills development and socio-emotional wellbeing and protect them against a host of adverse outcomes. However, schools are also places where ch…
Determinants of government spending on primary healthcare
In 2018 global leaders renewed their political commitment to primary healthcare (PHC) ratifying the Declaration of Astana emphasising the importance of building a sustainable PHC system based on accessible and affordable delivery models strengthened by community empowerment. Yet, PHC often remains underfunded, of poor quality, unreliable and not accountable to users which further deprives PHC of funding. This paper analyses the determinants of PH…
Understanding why EmpaTeach did not reduce teachers’ use of violence in Nyarugusu Refugee Camp
EmpaTeach was the first intervention to address teacher violence to be tested in a humanitarian setting and the first to focus on reducing impulsive use of violence, but a cluster randomised trial found no evidence that the intervention was effective in reducing physical and emotional violence from teachers. We aimed to understand why. We conducted a quantitative process evaluation to describe the intervention implementation process (what was imp…
Management Practices and Quality of Care
We measure the adoption of management practices in over 220 private for-profit and non-profit health facilities in 64 districts across Tanzania and link these data to process quality-of-care metrics, assessed using undercover standardised patients and clinical observations. We find that better managed health facilities are more likely to provide correct treatment in accordance with national treatment guidelines, adhere to a checklist of essential…
Inclusion of disability in primary healthcare facilities and socioeconomic inequity in Brazil
OBJECTIVE: To describe disability-related performance and inequality nationwide in Brazil, and the changes that took place between 2012 and 2019 after the introduction of Programme for Improving Primary Care Access and Quality (PMAQ). METHODS: We derived scores for disability-related care and accessibility of primary healthcare facilities from PMAQ indicators collected in round 1 (2011-2013), and round 3 (2015-2019). We assessed how scores change…
Understanding the municipal-level design and adaptation of pay-for-performance schemes across two states of Brazil
The design of complex health systems interventions, such as pay for performance (P4P), can be critical to determining such programmes’ success. In P4P programmes, the design of financial incentives is crucial in shaping how these programmes work. However, the design of such schemes is usually homogenous across providers within a given scheme. Consequently, there is a limited understanding of the strengths and weaknesses of P4P design elements fro…
Medicine (25 obras) · Economics (18 obras) · Business (16 obras) · Environmental health (16 obras) · Health care (16 obras) · Healthcare Systems and Reforms (16 obras) · Economic growth (15 obras) · Global Maternal and Child Health (13 obras) · Nursing (13 obras) · Healthcare Policy and Management (12 obras)