Lucy Gilson
Datos Biográficos
| ID | 3581816 |
|---|---|
| NOMBRE | Lucy Gilson |
| NOMBRES | Lucy |
| APELLIDO | Gilson |
| FIRMA | GILSON L |
| AFILIACIONES | University of Cape Town |
| ORCID | 0000-0002-2775-7703 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 111 |
| TOTAL DE CITAS | 834 |
| TOTAL COMO AUTOR | 111 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1987 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 13 |
Integration of ear and hearing care services in low- and middle-income health systems
Hearing loss is a global public health burden and mostly affects those living in low- and middle-income countries (LMICs). One approach to address ongoing challenges is the World Health Organization's recommendation for the integration of ear and hearing care (EHC) services into healthcare packages. However, little is known about EHC integration approaches, particularly in LMICs additionally, these approaches have not been investigated through a …
Celebrating the 40th anniversary of Health Policy and Planning
This year, 2026, we celebrate the 40th anniversary of this Journal, ‘Health Policy and Planning’. The journal was conceived in 1986 by Patrick Vaughan, Professor of Epidemiology at the London School of Hygiene and Tropical Medicine (LSHTM). We sadly marked his recent death in Issue 8 of 2025. He and Gill Walt, now Emeritus Professor of International Health Policy, were its founding editors; Anne Mills was co-editor in 1986/7 and 1993–2001 and rem…
Multi-actor collaborations in primary health care implementation
Bottom-up theory demonstrates that networks of actors play important roles in policy implementation, yet limited attention has so far been paid to the influence that actor networks might have on the implementation of primary health care (PHC) strategies and outcomes. This study examined the roles actor networks play in the implementation of Community-based Health Planning and Services (CHPS) in Ghana, focusing on the nature and patterns of relati…
Advancing health policy and systems research and analysis
Health systems are at a crossroads. Globally, health systems are straining under the weight of responding to persistent and emergent challenges. Uncertainties in health financing, service delivery, new technologies and disease burdens are hindering health systems abilities to maximize collective and scaled action to achieve health equity and social justice. In March 2025, a group of health policy and systems experts were convened by an organizati…
Responsibility without autonomy
Distributed leadership has been proposed to offer value for health systems—by enabling people to work towards collective goals within settings such as hospitals. Yet, there is still limited empirical exploration of its dynamics in practice, especially in low- and middle-income contexts. To address this knowledge gap, this case study draws on conceptual work in empirically examining leadership in one district hospital in the Western Cape province,…
Health systems as human systems
Health Policy and Systems Research (HPSR) plays a critical role in efforts to strengthen health systems in pursuit of the Sustainable Development Goals (SDGs). This manuscript, adapted from the 2024 Virchow Lecture, explores the nature of HPSR, presents a systems-thinking perspective on health systems, and outlines key principles and strategies toward health system strengthening. It emphasizes the human dimensions of health systems—relationships,…
The implementation gap
As temperatures rise due to climate change, so do adverse health effects. In response, many countries, including South Africa, have developed heat health action plans to address these threats to public health. In the Western Cape province, increasing heat events necessitate a well-coordinated response across governance levels and sectors. Understanding how heat risks are governed, particularly at subnational and local levels, is critical for safe…
Workplace-based learning in district health leadership and management strengthening
Effective leadership and management has been identified as critical in enabling health systems to respond adequately to their population needs. The changing nature of low- and middle-income countries’ health systems, given resource scarcity, a high disease burden and other contextual challenges, has also led to learning—including workplace-based learning (WPBL)—being recognized as a key process supporting health system reform and transformation. …
Initiating systemic capacity development for leadership from the bottom-up
The need for leadership within district health systems is critical for the effective delivery of services and for inter-sectoral collaboration for health. Leadership capacity development (LCD) has not, however, been prioritized within health systems, and the systemic capacity (i.e. roles, structures and processes) that is needed to develop managers who can lead is not always in place. This paper aims to contribute to understanding how to build su…
How has the concept of health system software been used in health policy and systems research? A scoping review
Understanding health systems as comprising interacting elements of hardware and software acknowledges health systems as complex adaptive systems (CASs). Hardware represents the concrete components of systems, whereas software represents the elements that influence actions and underpin relationships, such as processes, values, and norms. As a specific call for research on health system software was made in 2011, we conducted a qualitative scoping …
Obituary
Understanding health system responsiveness to public feedback at the sub-national level
Responsiveness is one of four health system goals alongside health outcomes, equity in financing and efficiency. Many studies examining responsiveness report a composite satisfaction index or proportions of patients describing satisfaction with dimensions of responsiveness. Consequently, responsiveness is predominantly based on collation of service users’ feedback and could be termed service responsiveness . We conceptualise system responsiveness…
Schools of public health as a cornerstone for pandemic preparedness and response
Editor-in-Chief changes at Health Policy and Planning
A story of (in)coherence
Climate adaptation strengthens and builds the resilience of health systems to future climate-related shocks. Adaptation strategies and policies are necessary tools for governments to address the long-term impacts of climate change and enable the health system to respond to current impacts such as extreme weather events. Since 2011 South Africa has national climate change policies and adaptation strategies, yet there is uncertainty about: how thes…
Power and positionality in the practice of health system responsiveness at sub-national level
Our findings illuminate the structures and mechanisms that contribute to weak health system responsiveness even in contexts where it is prioritised in policy documents. Supporting inclusion and participation of the public in feedback mechanisms can strengthen receipt of public feedback; however, measures to enhance public agency to participate are also needed. In addition, an organisational environment and culture that empowers health managers to…
A community-based ambulance model
The role of the emergency medical service (EMS) is changing globally as ambulance crews respond to a shifting burden of disease, as well as societal stressors such as violence and inequality. New ways of thinking about how to provide emergency care are required to shift EMS from a role primarily focused on clinical care and transporting patients to hospital. In this paper, we present the experience of the Philippi Project (PP), an innovative comm…
Examining sustained sub-national health system development
Governance and leadership are recognized as central to health system development in low- and middle-income countries, yet few existing studies consider the influence of multilevel governance systems. South Africa is one of the many (quasi-)federal states. Provincial governments have responsibility for managing health care delivery within national policy frameworks and norms. The early post-apartheid period saw country-wide efforts to address the …
Role of actor networks in primary health care implementation in low- and middle-income countries
BACKGROUND: Primary health care (PHC) improvement is often undermined by implementation gaps in low- and middle-income countries (LMICs). The influence that actor networks might have on the implementation has received little attention up to this point. OBJECTIVE: This study sought to offer insights about actor networks and how they support PHC implementation in LMICs. METHODS: We reviewed primary studies that utilised social network analysis (SNA…
A qualitative evaluation of priority-setting by the Health Benefits Package Advisory Panel in Kenya
Kenya’s Ministry of Health established the Health Benefits Package Advisory Panel (HBPAP) in 2018 to develop a benefits package for universal health coverage. This study evaluated HBPAP’s process for developing the benefits package against the normative procedural (acceptable way of doing things) and outcome (acceptable consequences) conditions of an ideal healthcare priority-setting process as outlined in the study’s conceptual framework. We con…
Incidence of catastrophic health spending in Indonesia
This study demonstrated that the overall incidence of CHS decreased in Indonesia between 2018 and 2019. OOP payments for health care and the risk of CHS still loom high among JKN members and among the lowest income households. More needs to be done to further contain OOP payments and further research is needed to investigate whether CHS pushes households below the poverty line
Health Policy and Planning ’s transition to Open Access
From 2024, Health Policy and Planning (HPP) will become a fully Open Access journal, in line with the overall trend in the publishing landscape. A few decades ago, almost all journals were based on subscriptions, paid by libraries, universities and research institutes. More recently, we have seen strong growth in Open Access journals, where the cost of publishing is covered by authors, their funders or employing organizations. At HPP, we have dem…
How does power shape district health management team responsiveness to public feedback in low- and middle-income countries
Responsiveness is a core element of World Health Organization’s health system framework, considered important for ensuring inclusive and accountable health systems. System-wide responsiveness requires system-wide action, and district health management teams (DHMTs) play critical governance roles in many health systems. However, there is little evidence on how DHMTs enhance health system responsiveness. We conducted this interpretive literature re…
Conceptual framework for systemic capacity strengthening for health policy and systems research
Health policy and systems research (HPSR) is critical in developing health systems to better meet the health needs of their populations. The highly contextualised nature of health systems point to the value of local knowledge and the need for context-embedded HPSR. Despite such need, relatively few individuals, groups or organisations carry out HPSR, particularly in low-income and middle-income countries. Greater effort is required to strengthen …
Should African governments contract out clinical health services to church providers
Trust and the development of health care as a social institution
Reforming the health sector in developing countries
Policy analysis is an established discipline in the industrialized world, yet its application to developing countries has been limited. The health sector in particular appears to have been neglected. This is surprising because there is a well recognized crisis in health systems, and prescriptions abound of what health policy reforms countries should introduce. However, little attention has been paid to how countries should carry out reforms, much…
Doing' health policy analysis
The case for undertaking policy analysis has been made by a number of scholars and practitioners. However, there has been much less attention given to how to do policy analysis, what research designs, theories or methods best inform policy analysis. This paper begins by looking at the health policy environment, and some of the challenges to researching this highly complex phenomenon. It focuses on research in middle and low income countries, draw…
We are bitter but we are satisfied
Trust and health worker performance
How to start thinking about investigating power in the organizational settings of policy implementation
Power, a concept at the heart of the health policy process, is surprisingly rarely explicitly considered in the health policy implementation literature for low and middle income countries. In an attempt to support empirical research on power, this paper outlines some of the key insights on power from implementation theory. It then describes examples of power that might be seen in health policy implementation settings, such as hospitals, clinics a…
The Lessons of User Fee Experience in Africa
This paper reviews the experience of implementing user fees in Africa. It describes the two main approaches to implementing user fees that have been applied in African countries, the standard and the Bamako Initiative models, and their common objectives. It summarizes the evidence concerning the impact of fees on equity, efficiency and system sustainability (as opposed to financial sustainability), and the key bottlenecks to their effective imple…
Putting equity in health back onto the social policy agenda
How can trust be investigated? Drawing lessons from past experience
Actor interfaces and practices of power in a community health worker programme
This paper makes a contribution to a much-neglected aspect of policy analysis: the practice of power in implementation. Practices of power are at the heart of every policy process, yet are rarely explicitly explored in the health policy literature. This paper provides a detailed study of micro-practices of power by those at the frontline of service delivery in the implementation of a national community health worker policy in one rural South Afri…
Community satisfaction with primary health care services
From bouncing back, to nurturing emergence
Recent health system shocks such as the Ebola disease outbreak have focused global health attention on the notion of resilient health systems. In this commentary, we reflect on the current framing of the concept of resilience in health systems discourse and propose a reframing. Specifically, we propose that: (1) in addition to sudden shocks, health systems face the ongoing strain of multiple factors. Health systems need the capacity to continue t…
Can frameworks inform knowledge about health policy processes? Reviewing health policy papers on agenda setting and testing them against a specific priority-setting framework
This article systematically reviews a set of health policy papers on agenda setting and tests them against a specific priority-setting framework. The article applies the Shiffman and Smith framework in extracting and synthesizing data from an existing set of papers, purposively identified for their relevance and systematically reviewed. Its primary aim is to assess how far the component parts of the framework help to identify the factors that inf…
A triple burden for health sector reform
The interface between research and policy
Explorations on people centredness in health systems
Health systems should ultimately seek to serve people and society. They must aim to bring value in people’s lives not only by caring for them when sick or giving support to prevent or limit illness and its effects, but also, more broadly, by offering the promise of economic security to all for times of great vulnerability. Health systems are also human systems. At their heart is a personal encounter, the interaction between the patient and the he…
Factors influencing implementation of the Community Health Fund in Tanzania
Although prepayment schemes are being hailed internationally as part of a solution to health care financing problems in low-income countries, literature has raised problems with such schemes. This paper reports the findings of a study that examined the factors influencing low enrollment in Tanzania's health prepayment schemes (Community Health Fund). The paper argues that district managers had a direct influence over the factors explaining low en…
The potential of health sector non-governmental organizations
Non-governmental organizations (NGOs) have increasingly been promoted as alternative health care providers to the state, furthering the same goals but less hampered by government inefficiencies and resource constraints. However, the reality of NGO health care provision is more complex. Not only is the distinction between government and NGO providers sometimes difficult to determine because of their operational integration, but NGOs may also suffe…
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…
Carrot and stick
The behavior of private sector health care providers will depend critically on the environment within which they operate. A bewildering array of possible regulatory and incentive setting structures exist. Most developing countries have the basic legislation for regulation, but there are frequently difficulties in enforcing such controls. While process aspects of quality of care regulation are often the responsibility of professional organizations…
Enabling relational leadership in primary healthcare settings
Strong management and leadership competencies have been identified as critical in enhancing health system performance. While the need for strong health system leadership has been raised, an important undertaking for health policy and systems researchers is to generate lessons about how to support leadership development (LD), particularly within the crisis-prone, resource poor contexts that are characteristic of Low- and Middle-Income health syste…
Private obstetric practice in a public hospital
Management and health care reform in sub-Saharan Africa
Action learning for health system governance
Health policy and systems research (HPSR) is centrally concerned with people, their relationships and the actions and practices they can implement towards better health systems. These concerns suggest that HPS researchers must work in direct engagement with the practitioners and practice central to the inquiry, acknowledging their tacit knowledge and drawing it into generating new insights into health system functioning. Social science perspectiv…
Mapping the existing body of health policy implementation research in lower income settings
This article uses 85 peer-reviewed articles published between 1994 and 2009 to characterize and synthesize aspects of the health policy analysis literature focusing on policy implementation in low- and middle-income countries (LMICs). It seeks to contribute, first, to strengthening the field of LMIC health policy analysis by highlighting gaps in the literature and generating ideas for a future research agenda and, second, to thinking about the va…
Swaziland
A Health Sector Financing and Expenditure (HSFE) survey was conducted in Swaziland against a background of growing concern about resource constraints on policy implementation. It sought to provide basic financial information which could be used when discussing policy options for addressing these constraints. Under a wide definition of the health sector, expenditure in 1984/85 was found to be equivalent to 9.8% of GDP and E73 ($US35) per capita. R…
Health sector financing
Journal Article Health sector financing: a response to Oscar Gish Get access LUCY GILSON LUCY GILSON Evaluation and Planning Centre for Health Care, London School of Hygiene and Tropical MedicineUK Search for other works by this author on: Oxford Academic PubMed Google Scholar Health Policy and Planning, Volume 3, Issue 1, March 1988, Pages 77–79, https://doi.org/10.1093/heapol/3.1.77 Published: 01 March 1988
Health surveys in developing countries
Diabetes in developing countries
The insulin dependent (IDDM) and non-insulin dependent (NIDDM) forms of diabetes mellitus were previously considered to be rare in most developing countries, but recent evidence shows that the frequency of NIDDM has risen rapidly in some developing country populations, particularly in Asia and the Western Pacific. Studies on the indirect and direct costs of diabetes, mainly from the USA, suggest that the economic burden due to the disease and its…
What is the future for equity within health policy
In spite of differences in meaning, equity is generally accepted as an important social and economic policy goal. However, recent policy debates suggest that this consensus is under challenge. This paper explores the current debate between the 'New Right' and its opponents, and how different approaches affect health policy. It is strongly argued that if equity is not to remain a misunderstood concept, it is essential to clarify the arguments in i…
Carrot and stick
The behavior of private sector health care providers will depend critically on the environment within which they operate. A bewildering array of possible regulatory and incentive setting structures exist. Most developing countries have the basic legislation for regulation, but there are frequently difficulties in enforcing such controls. While process aspects of quality of care regulation are often the responsibility of professional organizations…
The potential of health sector non-governmental organizations
Non-governmental organizations (NGOs) have increasingly been promoted as alternative health care providers to the state, furthering the same goals but less hampered by government inefficiencies and resource constraints. However, the reality of NGO health care provision is more complex. Not only is the distinction between government and NGO providers sometimes difficult to determine because of their operational integration, but NGOs may also suffe…
Reforming the health sector in developing countries
Policy analysis is an established discipline in the industrialized world, yet its application to developing countries has been limited. The health sector in particular appears to have been neglected. This is surprising because there is a well recognized crisis in health systems, and prescriptions abound of what health policy reforms countries should introduce. However, little attention has been paid to how countries should carry out reforms, much…
Community satisfaction with primary health care services
Public Hospitals in Developing Countries
Management and health care reform in sub-Saharan Africa
A triple burden for health sector reform
The Lessons of User Fee Experience in Africa
This paper reviews the experience of implementing user fees in Africa. It describes the two main approaches to implementing user fees that have been applied in African countries, the standard and the Bamako Initiative models, and their common objectives. It summarizes the evidence concerning the impact of fees on equity, efficiency and system sustainability (as opposed to financial sustainability), and the key bottlenecks to their effective imple…
Putting equity in health back onto the social policy agenda
The Saza study
This paper explores the policy-making process in the 1990s in two countries, South Africa and Zambia, in relation to health care financing reforms. While much of the analysis of health reform programmes has looked at design issues, assuming that a technically sound design is the primary requirement of effective policy change, this paper explores the political and bureaucratic realities shaping the pattern of policy change and its impacts. Through…
Trust and the development of health care as a social institution
We are bitter but we are satisfied
The performance of different models of primary care provision in Southern Africa
Removing user fees for primary care in Africa
Private obstetric practice in a public hospital
Trust and health worker performance
How can trust be investigated? Drawing lessons from past experience
Trust in health care
PURPOSE: This paper presents some key theoretical issues about trust, and seeks to demonstrate their relevance to understanding of, and research on, health systems. Although drawing particularly on empirical evidence from low- and middle-income countries (LMICs), the paper aims to stimulate thinking across country settings. DESIGN/METHODOLOGY/APPROACH: Drawing both on conceptual literature and relevant empirical research from LMICs, the paper pre…
Health systems and the implementation of disease programmes
This paper analyses the transfer and implementation of two internationally formulated infectious disease strategies in South Africa, namely, directly observed therapy (DOTS) for TB and syndromic management (SM) for sexually transmitted infections (STIs). Using the tools of policy analysis, this paper seeks to draw conclusions from contrasting experiences with the two strategies. DOTS and SM differ with respect to styles of engagement by World Hea…
Are health services protecting the livelihoods of the urban poor in Sri Lanka? Findings from two low-income areas of Colombo
Political science (85 obras) · Medicine (66 obras) · Global Maternal and Child Health (64 obras) · Economics (62 obras) · Public relations (61 obras) · Business (57 obras) · Health care (57 obras) · Economic growth (54 obras) · Sociology (48 obras) · Nursing (44 obras)