Kara Hanson
Dados Biográficos
| ID | 3581645 |
|---|---|
| NOME | Kara Hanson |
| PRENOMES | Kara |
| SOBRENOME | Hanson |
| ASSINATURA | HANSON K |
| AFILIAÇÕES | London School of Hygiene & Tropical Medicine |
| ORCID | 0000-0002-9928-2823 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 62 |
| TOTAL DE CITAÇÕES | 94 |
| TOTAL COMO AUTOR | 62 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1992 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 6 |
Reducing fragmentation of primary healthcare financing for more equitable, people-centred primary healthcare
Despite primary healthcare (PHC) being recognised in global declarations—Alma Ata in 1978 and Astana in 2018—and prioritised in national health strategies, chronic under-resourcing of PHC persists in most low-income and middle-income countries. More public spending is needed for PHC, but macrofiscal and political constraints often limit the ability of governments to allocate more public resources to PHC. Under-resourcing has been compounded by fr…
Stronger together
Box Global health research partnerships face persistent inequities, including funding imbalances, unbalanced recognition and inequitable recognition of low-and middle-income country (LMIC) researchers and their overall capacities
Co-developing a comprehensive disease policy model with stakeholders
Understanding the holistic impact of malaria during pregnancy is essential for improving maternal and child outcomes in malaria endemic settings. To be able to design appropriate research and conduct robust policy analyses, a comprehensive model of the underlying disease, representing the current understanding of mechanisms and consequences, is needed. This study aimed to illustrate a methodology to co-develop a disease policy model with expert s…
Still rethinking external assistance for health
As we revisited our April 2022 announcement of this special issue on Rethinking External Assistance for Health, we were struck by the increasing relevance of the themes that were raised (Shroff et al., 2022; HPP call for abstracts 2022). We are no longer speaking about the potential effects of the economic crisis triggered by COVID-19, but rather how countries and households are now experiencing the realities of fiscal tightening, increased sover…
Exploring the risks of fragmentation in health care markets - An analysis of inpatient care in Georgia
Private providers play an important role in health systems in low-and middle-income countries. In many such contexts, markets are characterized by a high number of relatively small private facilities. The potential risks from highly concentrated healthcare markets are well-researched, and feature in the "Theories of Harm" investigated by competition regulators. However, there is limited evidence on markets that exhibit substantial harms as a resu…
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…
Comparing estimates of household expenditures between pictorial diaries and surveys in three low- and middle-income countries
In most low- and middle-income countries (LMICs), household out-of-pocket (OOP) health spending constitutes a major source of healthcare financing. Household surveys are commonly used to monitor OOP health spending, but are prone to recall bias and unable to capture seasonal variation, and may underestimate expenditure–particularly among households with long-term chronic health conditions. Household expenditure diaries have been developed as an a…
Budget monitoring, accountability practices and their influence on the efficiency of county health systems in Kenya
Public Finance Management (PFM) practices influence the attainment of health system goals. PFM processes are implemented within the budget cycle which entails the formulation, execution, and monitoring of government budgets. Budget monitoring and accountability actors, structures, and processes are important in improving the efficiency of health systems. This study examined how the budget monitoring and accountability processes influence the effi…
Evaluating the effectiveness of the National Health Insurance Fund in providing financial protection to households with hypertension and diabetes patients in Kenya
We did not find strong evidence that the NHIF national scheme is effective in providing financial risk protection to households with individuals living with hypertension and/diabetes in Kenya. This could partly be explained by the low depth of cover of the NHIF national scheme, and the high attrition rate. To enhance NHIF effectiveness, there is a need to revise the NHIF benefit package to include essential hypertension and/diabetes services, rev…
The stated preferences of community-based volunteers for roles in the prevention of violence against women and girls in Ghana
Violence against women and girls (VAWG) is a human rights violation with substantial health-related consequences. Interventions to prevent VAWG, often implemented at the community level by volunteers, have been proven effective and cost-effective. One such intervention is the Rural Response System in Ghana, a volunteer-run program which hires community based action teams (COMBATs) to sensitise the community about VAWG and to provide counselling s…
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…
Rethinking external assistance for health
Coronavirus disease (COVID-19) and the subsequent economic crisis have raised questions about the long-term sustainability of external assistance for health and the interventions that it supports. New thinking is needed on how external assistance for health may best contribute to the sustainable coverage of essential health interventions embedded within countries’ efforts to make progress towards Universal Health Coverage (UHC). We propose a rese…
Linking health worker motivation with their stated job preferences
When technology precedes regulation
The recent growth of medicine sales online represents a major disruption to pharmacy markets, with COVID-19 encouraging this trend further. While e-pharmacy businesses were initially the preserve of high-income countries, in the past decade they have been growing rapidly in low-income and middle-income countries (LMICs). Public health concerns associated with e-pharmacy include the sale of prescription-only medicines without a prescription and th…
Can we do for other essential medicines what we are doing for the Covid-19 vaccine
box By the beginning of 2021 the world welcomed encouraging news on several candidate vaccines for COVID-19. Pfizer-BioNTech, Moderna, Oxford/AstraZeneca and the Chinese BBIBP-CorV vaccines are already rolled out in some high-income countries, and other vaccines may follow. While in low-income and middle-income countries (LMICs) access is lagging, there are several vaccines with significant potential for fighting the pandemic in those LMICs that …
Examining health sector stakeholder perceptions on the efficiency of county health systems in Kenya
Efficiency gains is a potential strategy to expand Kenya’s fiscal space for health. We explored health sector stakeholders’ understanding of efficiency and their perceptions of the factors that influence the efficiency of county health systems in Kenya. We conducted a qualitative cross-sectional study and collected data using three focus group discussions during a stakeholder engagement workshop. Workshop participants included health sector stake…
A dominance approach to analyze the incidence of catastrophic health expenditures in Iran
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…
Examining purchasing reforms towards universal health coverage by the National Hospital Insurance Fund in Kenya
While NHIF sought to expand population and service coverage and reduce out-of-pocket payments with the new reforms, weaknesses in the reforms' design and implementation limited NHIF's purchasing actions with negative implications for the health system goals of equity, efficiency and quality. For the reforms to accelerate the country's progress towards UHC, policy makers at the NHIF and, national and county government should make deliberate effort…
Malaria, medicines and miles
Nearly a decade after the adoption of confirmed diagnosis and artemisinin combination therapy (ACT) for the treatment of uncomplicated falciparum malaria, a large treatment gap persists. We describe a novel approach of combining data from households and the universe of treatment sources in their vicinities to produce nationally representative indicators of physical and financial access to malaria care from the household's perspective in Benin, Ni…
The State of Health Policy and Systems Research
The latest version of this event, the 5th Global Symposium on Health Systems Research, took place in Liverpool, UK from 8 to 12 October 2018, and drew 2247 participants from >125 countries—the largest gathering to date of health systems researchers from across the globe. Organized by Health Systems Global (HSG), it took place 40 years after the Alma-Ata Conference on Primary Health Care and 70 years after the creation of the United Kingdom’s Nati…
Measuring management practices in India's district public health bureaucracy
Does expanding fiscal space lead to improved funding of the health sector in developing countries
BACKGROUND: The global focus on promoting Universal Health Coverage has drawn attention to the need to increase public domestic funding for health care in low- and middle-income countries. OBJECTIVES: This article examines whether increased tax revenue in the three territories of Kenya, Lagos State (Nigeria) and South Africa was accompanied by improved resource allocation to their public health sectors, and explores the reasons underlying the obs…
Measuring financial protection against catastrophic health expenditures
Interpreting comparisons from global monitoring based on a single threshold should be done with caution as these may not provide reliable insight into relative country progress. We therefore recommend financial protection against catastrophic health expenditures be measured across a range of thresholds using a catastrophic incidence curve as shown in this paper. We further recommend evaluating financial protection in relation to a country's healt…
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…
Community financing of health care in Africa
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 …
Who benefits from free healthcare? Evidence from a randomized experiment in Ghana
Dalys
Towards universal coverage
This article examines why and how a national health insurance (NHI) proposal targeting universal health coverage (UHC) in Nigeria developed over time. The study involved document reviews, in-depth interviews, a further review of preliminary analysis by relevant actors and use of a stakeholder analysis approach. The need for strategies to improve healthcare funding during the economic recession of the 1980s stimulated the proposal. The inclusion o…
The economics of social marketing
Methods for studying private sector supply of public health products in developing countries
The use of specialty training to retain doctors in Malawi
Emigration has contributed to a shortage of doctors in many sub-Saharan African countries. Specialty training is highly valued by doctors and a potential tool for retention. Yet not all types of training may be valued equally. In the first study to examine preferences for postgraduate training in depth, we carried out a discrete choice experiment as part of a cross-sectional survey of all Malawian doctors within seven years of graduation and not …
Going beyond horizontal equity
Household demand for insecticide-treated bednets in Tanzania and policy options for increasing uptake
There has been considerable controversy about the most appropriate means of delivering insecticide-treated nets (ITNs) to prevent malaria. Household demand for ITNs is a key factor influencing the choice of delivery strategy, but evidence to date about price and income elasticities comes either from studies of hypothetical willingness to pay or small-scale policy experiments. This study estimates the price and income elasticities of demand for IT…
Do divergences between stated and actual willingness to pay signify the existence of bias in contingent valuation surveys
The Bamako Initiative
The Bamako Initiative was launched in September 1987 as a means of increasing access to essential drugs through community participation in revolving drug funds. The response of the public health community was highly critical of the Initiative. Issues raised included equity and access; problems of integration, management and logistics; the relative importance given to drugs; and sustainability and dependency. The Initiative has evolved in part in …
Linking health worker motivation with their stated job preferences
Measuring management practices in India's district public health bureaucracy
Specialty training for the retention of Malawian doctors
Exploring the risks of fragmentation in health care markets - An analysis of inpatient care in Georgia
Private providers play an important role in health systems in low-and middle-income countries. In many such contexts, markets are characterized by a high number of relatively small private facilities. The potential risks from highly concentrated healthcare markets are well-researched, and feature in the "Theories of Harm" investigated by competition regulators. However, there is limited evidence on markets that exhibit substantial harms as a resu…
Prices and mark-ups on antimalarials
The private for-profit sector is an important source of treatment for malaria. However, private patients face high prices for the recommended treatment for uncomplicated malaria, artemisinin combination therapies (ACTs), which makes them more likely to receive cheaper, less effective non-artemisinin therapies (nATs). This study seeks to better understand consumer antimalarial prices by documenting and exploring the pricing behaviour of retailers …
Growth of health maintenance organisations in Nigeria and the potential for a role in promoting universal coverage efforts
Predicting Consumption Expenditure for the Analysis of Health Care Financing Equity in Low Income Countries
Do equity funds protect the poor? Case studies from north-western Madagascar
BACKGROUND: User fees, if applied indiscriminately, have the potential to impose catastrophic costs on poor households at a time when a family member is sick and the household vulnerable. This can drive households into, or further into, poverty. In October 2003, Madagascar instituted a user fee policy that created 'equity funds' at public health centres to subsidize free medicine for the poor. OBJECTIVE: This study aims to assess the outcomes of …
Timing of delivery of malaria preventive interventions in pregnancy
BACKGROUND: Across sub-Saharan Africa, pregnant women attend routine health services around the 20th week of gestation. OBJECTIVE: To investigate, with a view to maximising effectiveness of malaria control tools delivered via routine services, coverage of an antenatal clinic insecticide-treated net (ITN) voucher scheme in Tanzania by gestational age. METHODS: Household and antenatal clinic survey data from 21 districts in Tanzania were collected …
Aids
AIDS is rapidly becoming a major health problem in developing countries. Limited empirical information is available about the impact of AIDS on the household, the community, the health sector and the broader economy. Special problems exist in estimating the direct economic costs of AIDS in developing countries, including large out-of-pocket expenditures on health care and shortages of drugs and supplies; the difficulties of valuing resources used…
Aids
AIDS is rapidly becoming a major health problem in developing countries. Limited empirical information is available about the impact of AIDS on the household, the community, the health sector and the broader economy. Special problems exist in estimating the direct economic costs of AIDS in developing countries, including large out-of-pocket expenditures on health care and shortages of drugs and supplies; the difficulties of valuing resources used…
The Bamako Initiative
The Bamako Initiative was launched in September 1987 as a means of increasing access to essential drugs through community participation in revolving drug funds. The response of the public health community was highly critical of the Initiative. Issues raised included equity and access; problems of integration, management and logistics; the relative importance given to drugs; and sustainability and dependency. The Initiative has evolved in part in …
Community financing of health care in Africa
Disability-adjusted life years
Dalys
Ends versus means
Achieving and sustaining universal access to contraceptives are key policy goals of interventions supplying contraceptive commodities. Donor support for contraceptive supplies is substantial and many public and national programmes rely on donated and subsidized supplies of contraceptives. Sustainability of programme benefits is a concern to both national governments and donor agencies. At the same time, market-based provision of contraceptives ha…
Methods for studying private sector supply of public health products in developing countries
Do divergences between stated and actual willingness to pay signify the existence of bias in contingent valuation surveys
The economics of social marketing
To Retain or Remove User Fees?
Vouchers for scaling up insecticide-treated nets in Tanzania
The M&E of the TNVS is a potential model for generating information to guide national and international programmers about options for delivering priority interventions. It is independent, comprehensive, provides timely results, includes information on intermediate processes to allow implementation to be modified, measures leakage as well as coverage, and measures progress over time
How to do (or not to do) … Designing a discrete choice experiment for application in a low-income country
Understanding the preferences of patients and health professionals is useful for health policy and planning. Discrete choice experiments (DCEs) are a quantitative technique for eliciting preferences that can be used in the absence of revealed preference data. The method involves asking individuals to state their preference over hypothetical alternative scenarios, goods or services. Each alternative is described by several attributes and the respo…
Building the Field of Health Policy and Systems Research
Following the First Global Symposium on Health Systems Research in Montreux in November 2010, PLoS Medicine commissioned three articles on the state-of-the-art in Health Policy and Systems Research (HPSR). Three Policy Forum articles, authored by a diverse group of global health academics, critically examine the current challenges to the field and lay out what is needed to build capacity in HPSR and support local policy development and health sys…
Building the Field of Health Policy and Systems Research
Following the First Global Symposium \non Health Systems Research in \nMontreux in November 2010, PLoS \nMedicine commissioned three articles \non the state-of-the-art in Health \nPolicy and Systems Research (HPSR). \nThree Policy Forum articles, authored \nby a diverse group of global \nhealth academics, critically examine \nthe current challenges to the field \nand lay out what is needed to build \ncapacity in HPSR and support local \npolicy de…
Constraints to universal coverage
There were inequities in use of the different providers, and also in expenditures on treatment. Reforms should aim to decrease barriers to access to public and formal health services and also identify constraints which impede the equitable distribution and access of public health services for the general population especially for poor people and rural dwellers
Household demand for insecticide-treated bednets in Tanzania and policy options for increasing uptake
There has been considerable controversy about the most appropriate means of delivering insecticide-treated nets (ITNs) to prevent malaria. Household demand for ITNs is a key factor influencing the choice of delivery strategy, but evidence to date about price and income elasticities comes either from studies of hypothetical willingness to pay or small-scale policy experiments. This study estimates the price and income elasticities of demand for IT…
Timing of delivery of malaria preventive interventions in pregnancy
BACKGROUND: Across sub-Saharan Africa, pregnant women attend routine health services around the 20th week of gestation. OBJECTIVE: To investigate, with a view to maximising effectiveness of malaria control tools delivered via routine services, coverage of an antenatal clinic insecticide-treated net (ITN) voucher scheme in Tanzania by gestational age. METHODS: Household and antenatal clinic survey data from 21 districts in Tanzania were collected …
Price subsidies and the market for mosquito nets in developing countries
Are the poor differentially benefiting from provision of priority public health services? A benefit incidence analysis in Nigeria
It is concluded that coverage of all of these priority public health services fell well below target levels, but the poorer quintiles and rural residents that are in greater need received more benefits, although not so for females. Payments for services that are supposed to be delivered free of charge suggests that there may have been illegal payments which probably hindered access to the public health services
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 …
Who benefits from free healthcare? Evidence from a randomized experiment in Ghana
Do equity funds protect the poor? Case studies from north-western Madagascar
BACKGROUND: User fees, if applied indiscriminately, have the potential to impose catastrophic costs on poor households at a time when a family member is sick and the household vulnerable. This can drive households into, or further into, poverty. In October 2003, Madagascar instituted a user fee policy that created 'equity funds' at public health centres to subsidize free medicine for the poor. OBJECTIVE: This study aims to assess the outcomes of …
Predicting Consumption Expenditure for the Analysis of Health Care Financing Equity in Low Income Countries
What determines providers' stated preference for the treatment of uncomplicated malaria
As agents for their patients, providers often make treatment decisions on behalf of patients, and their choices can affect health outcomes. However, providers operate within a network of relationships and are agents not only for their patients, but also other health sector actors, such as their employer, the Ministry of Health, and pharmaceutical suppliers. Providers' stated preferences for the treatment of uncomplicated malaria were examined to …
Equity in the allocation of public sector financial resources in low- and middle-income countries
Economics (47 obras) · Medicine (46 obras) · Business (40 obras) · Global Maternal and Child Health (40 obras) · Economic growth (37 obras) · Healthcare Systems and Reforms (30 obras) · Environmental health (27 obras) · Political science (27 obras) · Health care (22 obras) · Public economics (21 obras)