Nancy Kagwanja
Biographic Data
| ID | 6330899 |
|---|---|
| NAME | Nancy Kagwanja |
| GIVEN NAMES | Nancy |
| FAMILY NAME | Kagwanja |
| SIGNATURE | KAGWANJA N |
| AFFILIATIONS | Kenya Medical Research Institute |
| ORCID | 0000-0002-4411-4961 |
| VERIFIED | Yes |
| TOTAL WORKS | 12 |
| TOTAL CITATIONS | 4 |
| AUTHOR COUNT | 12 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2020 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 1 |
Understanding the role of ‘software’ in health system capacity for non-communicable disease response
Research on health system capacity to manage non-communicable diseases (NCDs) has largely focused on ‘system hardware’ such as infrastructure, workforce, and commodities. However, this overlooks the critical role of ‘system software’ elements, such as relationships, norms, and power, and the complex adaptive nature of health systems. This study aimed to explore how health system hardware and software elements interact to shape the capacity of the…
Understanding what factors influence community health worker involvement in hypertension service delivery in Kenya
The systematic involvement of community health workers (CHWs) in hypertension management can improve outcomes and achieve blood pressure control. However, much of this evidence is from effectiveness trials conducted under ideal conditions, with little evidence from programmes operating in routine conditions. In Kenya, recent policy changes have expanded CHW roles to routinely incorporate non-communicable disease (including hypertension) service d…
“It would be better for those of us who have the disease not to be ashamed”
Chronic hepatitis B infection (CHB) causes over 1 million deaths annually, with a large burden of morbidity and mortality in the WHO-African Region (WHO-AFRO) where
Implementing community-based interventions for the management of chronic conditions in low- and middle-income countries
The rising prevalence of chronic diseases in low- and middle-income countries (LMICs) poses significant challenges to already overburdened health systems. Community-based interventions are recognised as effective strategies for managing these conditions. However, implementing such interventions faces barriers that can hinder their effectiveness. This scoping review aims to assess qualitative studies examining barriers and facilitators to implemen…
Access to hypertension services and health-seeking experiences in rural Coastal Kenya
Globally, hypertension causes 10.8 million deaths annually. However, in Kenya, like in other low-and middle-income countries, access to hypertension care remains limited and inequitable. Understanding patients’ journeys in accessing care along the care cascade is critical to inform patient-centred care and policy improvements. This study aimed to explore patient experiences in accessing primary care services for hypertension along the care cascad…
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…
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…
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…
An innovative leadership development initiative to support building everyday resilience in health systems
Effective management and leadership are essential for everyday health system resilience, but actors charged with these roles are often underprepared and undersupported to perform them. Particular challenges have been observed in interpersonal and relational aspects of health managers’ work, including communication skills, emotional competence and supportive oversight. Within the Resilient and Responsive Health Systems (RESYST) consortium in Kenya…
Tracking health sector priority setting processes and outcomes for human resources for health, five-years after political devolution
Devolution has significantly increased county level decision-space for HRH priority setting in Kenya. However, HRH management and accountability challenges still exist at the county level. There is need for interventions to strengthen county level HRH management capacity and accountability mechanisms beyond additional resources allocation. This will boost the realization of the country's efforts for promoting service delivery equity as a key goal…
Prolonged health worker strikes in Kenya- perspectives and experiences of frontline health managers and local communities in Kilifi County
Strikes cannot be seen in isolation of the prevailing policy and health systems context. The 2017 prolonged strikes highlight the underlying and longer-term frustration amongst public sector health workers in Kenya. The health system exhibited properties of complex adaptive systems that are interdependent and interactive. Reactive responses within the public system and the use of private healthcare led to limited continued activity through the st…
Shocks, stress and everyday health system resilience
Health systems are faced with a wide variety of challenges. As complex adaptive systems, they respond differently and sometimes in unexpected ways to these challenges. We set out to examine the challenges experienced by the health system at a sub-national level in Kenya, a country that has recently undergone rapid devolution, using an ‘everyday resilience’ lens. We focussed on chronic stressors, rather than acute shocks in examining the responses…
Shocks, stress and everyday health system resilience
Health systems are faced with a wide variety of challenges. As complex adaptive systems, they respond differently and sometimes in unexpected ways to these challenges. We set out to examine the challenges experienced by the health system at a sub-national level in Kenya, a country that has recently undergone rapid devolution, using an ‘everyday resilience’ lens. We focussed on chronic stressors, rather than acute shocks in examining the responses…
Tracking health sector priority setting processes and outcomes for human resources for health, five-years after political devolution
Devolution has significantly increased county level decision-space for HRH priority setting in Kenya. However, HRH management and accountability challenges still exist at the county level. There is need for interventions to strengthen county level HRH management capacity and accountability mechanisms beyond additional resources allocation. This will boost the realization of the country's efforts for promoting service delivery equity as a key goal…
Prolonged health worker strikes in Kenya- perspectives and experiences of frontline health managers and local communities in Kilifi County
Strikes cannot be seen in isolation of the prevailing policy and health systems context. The 2017 prolonged strikes highlight the underlying and longer-term frustration amongst public sector health workers in Kenya. The health system exhibited properties of complex adaptive systems that are interdependent and interactive. Reactive responses within the public system and the use of private healthcare led to limited continued activity through the st…
Shocks, stress and everyday health system resilience
Health systems are faced with a wide variety of challenges. As complex adaptive systems, they respond differently and sometimes in unexpected ways to these challenges. We set out to examine the challenges experienced by the health system at a sub-national level in Kenya, a country that has recently undergone rapid devolution, using an ‘everyday resilience’ lens. We focussed on chronic stressors, rather than acute shocks in examining the responses…
An innovative leadership development initiative to support building everyday resilience in health systems
Effective management and leadership are essential for everyday health system resilience, but actors charged with these roles are often underprepared and undersupported to perform them. Particular challenges have been observed in interpersonal and relational aspects of health managers’ work, including communication skills, emotional competence and supportive oversight. Within the Resilient and Responsive Health Systems (RESYST) consortium in Kenya…
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…
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…
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…
“It would be better for those of us who have the disease not to be ashamed”
Chronic hepatitis B infection (CHB) causes over 1 million deaths annually, with a large burden of morbidity and mortality in the WHO-African Region (WHO-AFRO) where
Implementing community-based interventions for the management of chronic conditions in low- and middle-income countries
The rising prevalence of chronic diseases in low- and middle-income countries (LMICs) poses significant challenges to already overburdened health systems. Community-based interventions are recognised as effective strategies for managing these conditions. However, implementing such interventions faces barriers that can hinder their effectiveness. This scoping review aims to assess qualitative studies examining barriers and facilitators to implemen…
Access to hypertension services and health-seeking experiences in rural Coastal Kenya
Globally, hypertension causes 10.8 million deaths annually. However, in Kenya, like in other low-and middle-income countries, access to hypertension care remains limited and inequitable. Understanding patients’ journeys in accessing care along the care cascade is critical to inform patient-centred care and policy improvements. This study aimed to explore patient experiences in accessing primary care services for hypertension along the care cascad…
Understanding the role of ‘software’ in health system capacity for non-communicable disease response
Research on health system capacity to manage non-communicable diseases (NCDs) has largely focused on ‘system hardware’ such as infrastructure, workforce, and commodities. However, this overlooks the critical role of ‘system software’ elements, such as relationships, norms, and power, and the complex adaptive nature of health systems. This study aimed to explore how health system hardware and software elements interact to shape the capacity of the…
Understanding what factors influence community health worker involvement in hypertension service delivery in Kenya
The systematic involvement of community health workers (CHWs) in hypertension management can improve outcomes and achieve blood pressure control. However, much of this evidence is from effectiveness trials conducted under ideal conditions, with little evidence from programmes operating in routine conditions. In Kenya, recent policy changes have expanded CHW roles to routinely incorporate non-communicable disease (including hypertension) service d…
Global Maternal and Child Health (8 works) · Medicine (7 works) · Political science (7 works) · Economics (6 works) · Health care (6 works) · Nursing (6 works) · Sociology (6 works) · Healthcare Systems and Reforms (5 works) · Public health (5 works) · Public relations (5 works)