Susan Cleary
Dados Biográficos
| ID | 3581654 |
|---|---|
| NOME | Susan Cleary |
| PRENOMES | Susan |
| SOBRENOME | Cleary |
| ASSINATURA | CLEARY S |
| AFILIAÇÕES | University of Cape Town |
| ORCID | 0000-0002-9071-7958 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 25 |
| TOTAL DE CITAÇÕES | 56 |
| TOTAL COMO AUTOR | 25 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2006 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 5 |
Socioeconomic inequality in the outcomes of a psychological intervention for depression for South Africans with a co-occurring chronic disease
Task-shared psychological interventions are effective for reducing the severity of depression symptoms, but differences in treatment outcome by socioeconomic status is uncertain. This study examines socioeconomic inequalities (SEI) in depression outcomes among people with HIV and/or diabetes who participated in a cluster randomised controlled trial in the Western Cape Province of South Africa. The trial took place at 24 primary care clinics rando…
Comparing the effectiveness and cost-effectiveness of alternative type 2 diabetes monitoring intervals in resource limited settings
Type 2 diabetes (T2D) represents a growing disease burden in South Africa. While glycated haemoglobin (HbA1c) testing is the gold standard for long-term blood glucose management, recommendations for HbA1c monitoring frequency are based on expert opinion. This study investigates the effectiveness and cost-effectiveness of alternative HbA1c monitoring intervals in the management of T2D. A Markov model with three health states (HbA1c <7%, HbA1c ≥ 7%…
Social determinants of health and diabetes self-care management in South Africa
The associations between SDoH and diabetes self-care management within a South African context highlight the need for a more holistic understanding and approach to interventions. Future endeavours should examine these determinants more broadly and formulate integrative strategies to ameliorate diabetes self-care
The economic burden of chronic diseases with co-occurring depression and alcohol use disorder for people in the Western Cape, South Africa
There is limited evidence on the economic burden of chronic diseases with co-occurring depression and alcohol use disorder (AUD) for people in low-and middle-income countries. We describe patient costs related to the utilisation of services and identify factors associated with the economic burden of co-occurring depression and AUD for people with HIV and/or diabetes using government health services in South Africa. We used baseline data from part…
Economic evaluation of psychological treatments for common mental disorders in low- and middle-income countries
Common mental disorders (CMDs) constitute a major public health and economic burden on low- and middle-income countries (LMICs). Systematic reviews of economic evaluations of psychological treatments for CMDs are limited. This systematic review examines methods, reports findings and appraises the quality of economic evaluations of psychological treatments for CMDs in LMICs. We searched a range of bibliographic databases (including PubMed, EconLit…
A cost analysis of a sports-based sexual health education programme for adolescent girls in South African schools
Studies have shown that school-based sexual health promotion interventions can improve adolescent sexual and reproductive health outcomes. However, there has been insufficient evidence on the cost and cost-effectiveness of such programmes, driving poor and inconsistent investment and prioritization. This paper analyses the costs of the SKILLZ Health for Girls programme, a sports-based sexual education intervention targeted at adolescent girls in …
Stepped care to optimize pre-exposure prophylaxis (PrEP) effectiveness in pregnant and postpartum women (SCOPE-PP) in South Africa
NCT05322629 : Date of registration: April 12, 2022
Economic evaluations of psychological treatments for common mental disorders in low- and middle-income countries
Economic evaluation and health systems strengthening
Health systems strengthening (HSS) is firmly on the global health and development agenda. While a growing evidence base seeks to understand the effectiveness of HSS, there is limited evidence regarding cost and cost-effectiveness. Without such evidence, it is hard to argue that HSS represents value for money and the level of investment needed cannot be quantified. This paper seeks to review the literature regarding the economic evaluation of HSS …
Mental health system costs, resources and constraints in South Africa
The inclusion of mental health in the Sustainable Development Goals represents a global commitment to include mental health among the highest health and development priorities for investment. Low- and middle-income countries (LMICs), such as South Africa, contemplating mental health system scale-up embedded into wider universal health coverage-related health system transformations, require detailed and locally derived estimates on existing mental…
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…
The everyday practice of supporting health system development
Health system strengthening (HSS) has often been undertaken by global health actors working through vertical programmes. However, experience has shown the challenges of this approach, and the need to recognize health systems as open complex adaptive systems-which in turn has implications for the design and implementation approach of more 'horizontal' HSS interventions. From 2009 to 2016, the Doris Duke Charitable Foundation supported the African …
Everyday resilience in district health systems
Recent global crises have brought into sharp relief the absolute necessity of resilient health systems that can recognise and react to societal crises. While such crises focus the global mind, the real work lies, however, in being resilient in the face of routine, multiple challenges. But what are these challenges and what is the work of nurturing everyday resilience in health systems? This paper considers these questions, drawing on long-term, p…
Hospitals as complex adaptive systems
There is a dearth of literature on priority setting and resource allocation (PSRA) practices in hospitals, particularly in low and middle income countries (LMICs). Using a case study approach, we examined PSRA practices in 2 public hospitals in coastal Kenya. We collected data through a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of…
Setting healthcare priorities
This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month p…
Does treatment collection and observation each day keep the patient away? An analysis of the determinants of adherence among patients with Tuberculosis in South Africa
Directly observed treatment short course (DOTS) has been the recommended strategy for Tuberculosis (TB) control since 1995. Developed as an alternative to inpatient treatment, it involves observation of patients' medication intake to promote adherence. However, the burden of daily clinic visits may affect access to care. Using a mixed methods approach, we consider whether (1) non-adherence differs systematically between patients required to make …
Setting healthcare priorities in hospitals
Priority setting research has focused on the macro (national) and micro (bedside) level, leaving the meso (institutional, hospital) level relatively neglected. This is surprising given the key role that hospitals play in the delivery of healthcare services and the large proportion of health systems resources that they absorb. To explore the factors that impact upon priority setting at the hospital level, we conducted a thematic review of empirica…
The economic burden of TB diagnosis and treatment in South Africa
Social protection against the cost of illness is a central policy objective of Universal Health Coverage and the post-2015 Global strategy for Tuberculosis (TB). Understanding the economic burden associated with TB illness and care is key to identifying appropriate interventions towards achieving this target. The aims of this study were to identify points in patient pathways from start of TB symptoms to treatment completion where interventions co…
Investigating the affordability of key health services in South Africa
Naming Cheese
The following essays were written by members of the Cheese Scholars Collective. Formed during a workshop held 24–26 June 2009 in Totnes, Devon, England, the Collective is dedicated to faci1itating the constructive exchange of scholarly perspectives on cheese and its makers. The short essay form of these papers is intended to allow for a more productive juxtaposition of the authors' ideas, and to better convey the array of forms their shared objec…
Socioeconomic status and barriers to the use of free antiretroviral treatment for HIV/Aids in Enugu State, south-eastern Nigeria
With about 3 million people living with HIV, Nigeria has approximately 8% of the global burden of HIV cases. In 2009, only about 34% of those in need of antiretroviral treatment (ART) were able to access care, which means that Nigeria was far from achieving the United Nations target of 'universal access' by 2010. This study aimed to describe the barriers to accessibility and the coping strategies employed to overcome these barriers among users of…
Does accessibility to antiretroviral care improve after down-referral of patients from hospitals to health centres in rural South Africa
We conducted an evaluation of healthcare accessibility among patients taking antiretroviral treatment (ART) after they were 'down-referred' from hospital-based programmes to primary healthcare (PHC) centres in a rural South African setting. A cross-sectional design was used to study 109 PHC users compared to a randomly selected control group of 220 hospital-based users. Both groups were matched for a minimum duration on ART of six months. Using a…
Claims on health care
Trying to determine how best to allocate resources in health care is especially difficult when resources are severely constrained, as is the case in all developing countries. This is particularly true in South Africa currently where the HIV epidemic adds significantly to a health service already overstretched by the demands made upon it. This paper proposes a framework for determining how best to allocate scarce health care resources in such circ…
Commentary
This commentary focuses on how the cost-effectiveness of a chosen HIV treatment strategy has an influence on the costs of scaling up as well as the constraints of going to scale and ultimately on coverage or equitable access for all in need. It concludes that if there are constraints to achieving equitable access to more effective forms of ART then the more cost-effective forms of care might allow for higher access to care for those in need.
Does public opinion influence willingness-to-pay? Evidence from the field
Contingent valuation (CV) surveys have been criticized for assuming that respondents have well-defined preferences. Using an innovative field experiment dealing with a privatized public good, it is shown that respondents are not influenced by public opinion but are positively responsive to scientific information
Mental health system costs, resources and constraints in South Africa
The inclusion of mental health in the Sustainable Development Goals represents a global commitment to include mental health among the highest health and development priorities for investment. Low- and middle-income countries (LMICs), such as South Africa, contemplating mental health system scale-up embedded into wider universal health coverage-related health system transformations, require detailed and locally derived estimates on existing mental…
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…
Hospitals as complex adaptive systems
There is a dearth of literature on priority setting and resource allocation (PSRA) practices in hospitals, particularly in low and middle income countries (LMICs). Using a case study approach, we examined PSRA practices in 2 public hospitals in coastal Kenya. We collected data through a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of…
The economic burden of TB diagnosis and treatment in South Africa
Social protection against the cost of illness is a central policy objective of Universal Health Coverage and the post-2015 Global strategy for Tuberculosis (TB). Understanding the economic burden associated with TB illness and care is key to identifying appropriate interventions towards achieving this target. The aims of this study were to identify points in patient pathways from start of TB symptoms to treatment completion where interventions co…
Naming Cheese
The following essays were written by members of the Cheese Scholars Collective. Formed during a workshop held 24–26 June 2009 in Totnes, Devon, England, the Collective is dedicated to faci1itating the constructive exchange of scholarly perspectives on cheese and its makers. The short essay form of these papers is intended to allow for a more productive juxtaposition of the authors' ideas, and to better convey the array of forms their shared objec…
Investigating the affordability of key health services in South Africa
The everyday practice of supporting health system development
Health system strengthening (HSS) has often been undertaken by global health actors working through vertical programmes. However, experience has shown the challenges of this approach, and the need to recognize health systems as open complex adaptive systems-which in turn has implications for the design and implementation approach of more 'horizontal' HSS interventions. From 2009 to 2016, the Doris Duke Charitable Foundation supported the African …
Does treatment collection and observation each day keep the patient away? An analysis of the determinants of adherence among patients with Tuberculosis in South Africa
Directly observed treatment short course (DOTS) has been the recommended strategy for Tuberculosis (TB) control since 1995. Developed as an alternative to inpatient treatment, it involves observation of patients' medication intake to promote adherence. However, the burden of daily clinic visits may affect access to care. Using a mixed methods approach, we consider whether (1) non-adherence differs systematically between patients required to make …
Socioeconomic inequality in the outcomes of a psychological intervention for depression for South Africans with a co-occurring chronic disease
Task-shared psychological interventions are effective for reducing the severity of depression symptoms, but differences in treatment outcome by socioeconomic status is uncertain. This study examines socioeconomic inequalities (SEI) in depression outcomes among people with HIV and/or diabetes who participated in a cluster randomised controlled trial in the Western Cape Province of South Africa. The trial took place at 24 primary care clinics rando…
Does public opinion influence willingness-to-pay? Evidence from the field
Contingent valuation (CV) surveys have been criticized for assuming that respondents have well-defined preferences. Using an innovative field experiment dealing with a privatized public good, it is shown that respondents are not influenced by public opinion but are positively responsive to scientific information
Commentary
This commentary focuses on how the cost-effectiveness of a chosen HIV treatment strategy has an influence on the costs of scaling up as well as the constraints of going to scale and ultimately on coverage or equitable access for all in need. It concludes that if there are constraints to achieving equitable access to more effective forms of ART then the more cost-effective forms of care might allow for higher access to care for those in need.
Socioeconomic status and barriers to the use of free antiretroviral treatment for HIV/Aids in Enugu State, south-eastern Nigeria
With about 3 million people living with HIV, Nigeria has approximately 8% of the global burden of HIV cases. In 2009, only about 34% of those in need of antiretroviral treatment (ART) were able to access care, which means that Nigeria was far from achieving the United Nations target of 'universal access' by 2010. This study aimed to describe the barriers to accessibility and the coping strategies employed to overcome these barriers among users of…
Does accessibility to antiretroviral care improve after down-referral of patients from hospitals to health centres in rural South Africa
We conducted an evaluation of healthcare accessibility among patients taking antiretroviral treatment (ART) after they were 'down-referred' from hospital-based programmes to primary healthcare (PHC) centres in a rural South African setting. A cross-sectional design was used to study 109 PHC users compared to a randomly selected control group of 220 hospital-based users. Both groups were matched for a minimum duration on ART of six months. Using a…
Claims on health care
Trying to determine how best to allocate resources in health care is especially difficult when resources are severely constrained, as is the case in all developing countries. This is particularly true in South Africa currently where the HIV epidemic adds significantly to a health service already overstretched by the demands made upon it. This paper proposes a framework for determining how best to allocate scarce health care resources in such circ…
Naming Cheese
The following essays were written by members of the Cheese Scholars Collective. Formed during a workshop held 24–26 June 2009 in Totnes, Devon, England, the Collective is dedicated to faci1itating the constructive exchange of scholarly perspectives on cheese and its makers. The short essay form of these papers is intended to allow for a more productive juxtaposition of the authors' ideas, and to better convey the array of forms their shared objec…
Investigating the affordability of key health services in South Africa
Setting healthcare priorities in hospitals
Priority setting research has focused on the macro (national) and micro (bedside) level, leaving the meso (institutional, hospital) level relatively neglected. This is surprising given the key role that hospitals play in the delivery of healthcare services and the large proportion of health systems resources that they absorb. To explore the factors that impact upon priority setting at the hospital level, we conducted a thematic review of empirica…
The economic burden of TB diagnosis and treatment in South Africa
Social protection against the cost of illness is a central policy objective of Universal Health Coverage and the post-2015 Global strategy for Tuberculosis (TB). Understanding the economic burden associated with TB illness and care is key to identifying appropriate interventions towards achieving this target. The aims of this study were to identify points in patient pathways from start of TB symptoms to treatment completion where interventions co…
Setting healthcare priorities
This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month p…
Does treatment collection and observation each day keep the patient away? An analysis of the determinants of adherence among patients with Tuberculosis in South Africa
Directly observed treatment short course (DOTS) has been the recommended strategy for Tuberculosis (TB) control since 1995. Developed as an alternative to inpatient treatment, it involves observation of patients' medication intake to promote adherence. However, the burden of daily clinic visits may affect access to care. Using a mixed methods approach, we consider whether (1) non-adherence differs systematically between patients required to make …
Everyday resilience in district health systems
Recent global crises have brought into sharp relief the absolute necessity of resilient health systems that can recognise and react to societal crises. While such crises focus the global mind, the real work lies, however, in being resilient in the face of routine, multiple challenges. But what are these challenges and what is the work of nurturing everyday resilience in health systems? This paper considers these questions, drawing on long-term, p…
Hospitals as complex adaptive systems
There is a dearth of literature on priority setting and resource allocation (PSRA) practices in hospitals, particularly in low and middle income countries (LMICs). Using a case study approach, we examined PSRA practices in 2 public hospitals in coastal Kenya. We collected data through a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of…
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…
The everyday practice of supporting health system development
Health system strengthening (HSS) has often been undertaken by global health actors working through vertical programmes. However, experience has shown the challenges of this approach, and the need to recognize health systems as open complex adaptive systems-which in turn has implications for the design and implementation approach of more 'horizontal' HSS interventions. From 2009 to 2016, the Doris Duke Charitable Foundation supported the African …
Mental health system costs, resources and constraints in South Africa
The inclusion of mental health in the Sustainable Development Goals represents a global commitment to include mental health among the highest health and development priorities for investment. Low- and middle-income countries (LMICs), such as South Africa, contemplating mental health system scale-up embedded into wider universal health coverage-related health system transformations, require detailed and locally derived estimates on existing mental…
Economic evaluations of psychological treatments for common mental disorders in low- and middle-income countries
Economic evaluation and health systems strengthening
Health systems strengthening (HSS) is firmly on the global health and development agenda. While a growing evidence base seeks to understand the effectiveness of HSS, there is limited evidence regarding cost and cost-effectiveness. Without such evidence, it is hard to argue that HSS represents value for money and the level of investment needed cannot be quantified. This paper seeks to review the literature regarding the economic evaluation of HSS …
A cost analysis of a sports-based sexual health education programme for adolescent girls in South African schools
Studies have shown that school-based sexual health promotion interventions can improve adolescent sexual and reproductive health outcomes. However, there has been insufficient evidence on the cost and cost-effectiveness of such programmes, driving poor and inconsistent investment and prioritization. This paper analyses the costs of the SKILLZ Health for Girls programme, a sports-based sexual education intervention targeted at adolescent girls in …
Stepped care to optimize pre-exposure prophylaxis (PrEP) effectiveness in pregnant and postpartum women (SCOPE-PP) in South Africa
NCT05322629 : Date of registration: April 12, 2022
The economic burden of chronic diseases with co-occurring depression and alcohol use disorder for people in the Western Cape, South Africa
There is limited evidence on the economic burden of chronic diseases with co-occurring depression and alcohol use disorder (AUD) for people in low-and middle-income countries. We describe patient costs related to the utilisation of services and identify factors associated with the economic burden of co-occurring depression and AUD for people with HIV and/or diabetes using government health services in South Africa. We used baseline data from part…
Economic evaluation of psychological treatments for common mental disorders in low- and middle-income countries
Common mental disorders (CMDs) constitute a major public health and economic burden on low- and middle-income countries (LMICs). Systematic reviews of economic evaluations of psychological treatments for CMDs are limited. This systematic review examines methods, reports findings and appraises the quality of economic evaluations of psychological treatments for CMDs in LMICs. We searched a range of bibliographic databases (including PubMed, EconLit…
Comparing the effectiveness and cost-effectiveness of alternative type 2 diabetes monitoring intervals in resource limited settings
Type 2 diabetes (T2D) represents a growing disease burden in South Africa. While glycated haemoglobin (HbA1c) testing is the gold standard for long-term blood glucose management, recommendations for HbA1c monitoring frequency are based on expert opinion. This study investigates the effectiveness and cost-effectiveness of alternative HbA1c monitoring intervals in the management of T2D. A Markov model with three health states (HbA1c <7%, HbA1c ≥ 7%…
Social determinants of health and diabetes self-care management in South Africa
The associations between SDoH and diabetes self-care management within a South African context highlight the need for a more holistic understanding and approach to interventions. Future endeavours should examine these determinants more broadly and formulate integrative strategies to ameliorate diabetes self-care
Socioeconomic inequality in the outcomes of a psychological intervention for depression for South Africans with a co-occurring chronic disease
Task-shared psychological interventions are effective for reducing the severity of depression symptoms, but differences in treatment outcome by socioeconomic status is uncertain. This study examines socioeconomic inequalities (SEI) in depression outcomes among people with HIV and/or diabetes who participated in a cluster randomised controlled trial in the Western Cape Province of South Africa. The trial took place at 24 primary care clinics rando…
Medicine (19 obras) · Environmental health (14 obras) · Business (12 obras) · Economics (11 obras) · Nursing (10 obras) · Economic growth (9 obras) · Global Maternal and Child Health (9 obras) · Health care (9 obras) · Political science (9 obras) · Population (9 obras)