Regulatory Challenges in A Complex Emergency Environment: An update on South Sudan (original) (raw)
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Objective: To explore the feasibility of health systems strengthening from the perspective of international healthcare implementers and donors in South Sudan. Design: A qualitative interview study, with thematic analysis using the WHO health system building blocks framework. Setting: South Sudan. Participants: 17 health system practitioners, working for international agencies in South Sudan, were purposively sampled for their knowledge and experiences of health systems strengthening, services delivery, health policy and politics in South Sudan. Results: Participants universally reported the health workforce as insufficient and of low capacity and service delivery as poor, while access to medicines was restricted by governmental lack of commitment in undertaking procurement and supply. However, progress was clear in improved county health department governance, health management information system functionality, increased health worker salary harmonisation and strengthened financial management. Conclusions: Resurgent conflict and political tensions have negatively impacted all health system components and maintaining or continuing health system strengthening has become extremely challenging. A coordinated approach to balancing humanitarian need particularly in conflict-affected areas, with longer term development is required so as not to lose improvements gained.
Saving the Fundaments: Impact of a Military Coup on the Sudan Health System
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Military coups are not uncommon occurrences, particularly in developing nations where political systems might be less firmly entrenched or still evolving. Developments of this nature can often have profound implications for the affected nation’s healthcare systems, both in the immediate aftermath and over the longer term. This paper narrates some notable consequences of political instability on the national health system, particularly placing them in the context of the military coup in October 2021 – emphasizing the context behind the political turbulence, its acute and direct consequences, and the possible long-term legacies of political shocks on the already overwhelmed health system. As a descriptive piece, this narrative does not only look at the impact of the military coup on hospitals, but considers the implications for the healthcare system as defined by the WHO, with particular emphasis on the impact of the coup on health funding from multi-laterals, service delivery, human ...
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This thesis examines the best system for health professions regulation in Ethiopia with a view to sketch the roles of state and non-state actors in that system. It argues for statist regulation as self-regulation is worrisome for its tendency to promote private interest instead over public protection. A statist regulation is an efficient system that is more capable of establishing accountable and procedurally fair processes and strengthening public trust than a system of self-regulation. But the state lacks capacity, expertise, and legitimacy, and risks capture and corruption. These could be resolved through an enforcement strategy rooted in responsive regulation theory. That strategy should emphasize soft regulatory instruments, which requires utilization of the capacity and motivation of non-state actors, particularly health professional associations. A statist regulatory framework that harnesses the contribution of non-state actors in implementing soft regulatory strategies would effectively protect patients and improve the quality of health care services in Ethiopia.
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Health sector recovery in early post-conflict environments: experience from southern Sudan
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Health sector recovery in post-conflict settings presents an opportunity for reform: analysis of policy processes can provide useful lessons. 2 The case of southern Sudan is assessed through interviews, a literature review, and by drawing on the experience of former technical advisers to the Ministry of Health. In the immediate post-conflict phase, the health system in southern Sudan was characterised by fragmentation, low coverage of health services, dismal health outcomes and limited government capacity. Health policy was extensively shaped by the interplay of context, actors and processes: the World Bank and the World Health Organization became the primary drivers of policy change. Lessons learned from the southern Sudan case include the need for: sustained investment in assessment and planning of recovery activities; building of procurement capacity early in the recovery process; support for funding instruments that can disburse resources rapidly; and streamlining the governance structures and procedures adopted by health recovery financing mechanisms and adapting them to the local context.
Regulation of the Private Health Sector in Ethiopia: Review of the Legal and Institutional Frameworks, 2025
Health service provision and its regulation are the constitutional responsibilities of the government. As expressly provided under Articles 44 and 90 of the FDRE Constitution, the government has to ensure access to public health, clean water, food, and a healthy environment. In light of this, many legislative measures have been taken along with the establishment of the Ethiopian Food and Drug Administration as the principal regulatory body. Ministry of Health and Ethiopian Public Health Institute has also some regulatory power in addition to their mainstream roles, i.e. the provision of health services and research in their respective order. So far, there is no distinct legal framework governing the private health sector; instead, both public and private sectors are largely regulated under the same laws. While registration and licensing, quality standards, and inspections are regulatory tools, administrative measures like suspension or revocation of licenses and closure of the undertaking, and/or additional civil and criminal liabilities are compliance mechanisms mainly for the private sector. However, legal fragmentation, multiplicity of regulatory institutions, and diversity of regulators stand as apparent drawbacks in health sector regulation. The provision of health services and expanding its coverage on the one hand, and regulating the same service on the other hand, may conflict, and thus could not be effectively managed together by the same institutions. Regulation of the health service needs focus and relative institutional autonomy. Thus, to effectively ensure the health services compliance with health and safety standards, establishing a single non-fragmented regulator empowered on all health issues, be it food, medicine, healthcare, or related matters plays a key role. Hence, amassing and systematically codifying health laws into a single legislation could make them less troubling and more understandable.
Attacks on health system in South Sudan
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Complex emergencies have been defined as “relatively acute situations affecting large civilian populations, usually involving a combination of war or civil strife, food shortages and population displacement, resulting in significant excess mortality” Armed conflict causes an enormous amount of death and disability worldwide. It destroys families, communities and cultures. It diverts scarce resources. It disrupts the societal infrastructure that supports health. It forces people to leave their homes and become internally displaced persons or refugees who have fled to other countries. It violates human rights. It promotes violence as a means to resolve conflicts and it degrades the environment. Armed conflict has an even more profound effect on lowand middle-income countries. Health professionals can play important roles in minimizing the adverse consequences of war and in preventing war itself provide evidence for conflict resolution efforts, we carried out retrospective documents an...
Journal of Pharmaceutical Policy and Practice, 2020
Background Access to quality-assured, safe and efficacious medical products is fundamental for Universal Health Coverage and attaining Sustainable Development Goal 3: Ensure Healthy Lives and Well-being for All. To guarantee this right, there is a need for robust and efficiently performing national regulatory systems for the regulation of medical products. Well-functioning regulatory systems apply globally accepted standards which ensure that the level of control is proportionate to the level of public health risk. Objective of the study The study aimed at analysing the regulatory systems for medical products in the 16 Member States of the Southern African Development Community (SADC). It provides an overview of the national regulatory systems for medical products in the region in 2017 and outlines the institutional frameworks, which enable the implementation of regulatory functions. Methodology A survey was conducted in March-December 2017 in English, French and Portuguese. Nationa...
GSP Forum 345 Health governance in Sub-Saharan Africa
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The advent of global health governance means health administration that transcends national boundaries. In view of the interdependence of states and increasing movement of people, the spread of contagious diseases and the heightened complexity of global health issues make cooperation among countries to be indispensable. Unfortunately resourcing remains a critical challenge to effective health governance. The uncontrolla-ble spread of Ebola in West Africa in 2014 is a good case example of the impact of lim-ited financial and human resources in combating highly contagious diseases that are a potential global threat to human life. It is important to note from the onset that health governance borders on human rights, essentially the right to life. It is for this reason that health needs to remain a top priority for all nations, rich and poor. The disparity in terms of the quality of healthcare and health service provision in developed and developing countries is apparent. ‘Good governan...