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Search Results: 1 - 10 of 44 matches for " Joses Kirigia "
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The essence of governance in health development
Joses Kirigia, Doris Kirigia
International Archives of Medicine , 2011, DOI: 10.1186/1755-7682-4-11
Abstract: We argue that unlike 'leadership in health development', 'governance in health development' is the sole prerogative of the Government through the Ministry of Health, which can choose to delegate (but not abrogate) some of the governance tasks. The general governance domains of the UNDP and the World Bank are very pertinent but not sufficient for assessment of health development governance. The WHO six domains of governance do not include effective external partnerships for health, equity in health development, efficiency in resource allocation and use, ethical practises in health research and service provision, and macroeconomic and political stability. The framework for assessing health systems governance developed by Siddiqi et al also does not include macroeconomic and political stability as a separate principle. The Siddiqi et al framework does not propose a way of scoring the various governance domains to facilitate aggregation, inter-country comparisons and health development governance tracking over time.This paper argues for a broader health development governance framework because other sectors that assure human rights to education, employment, food, housing, political participation, and security combined have greater impact on health development than the health systems. It also suggests some amendments to Siddigi et al's framework to make it more relevant to the broader concept of 'governance in health development' and to the WHO African Region context.A strong case for broader health development governance framework has been made. A health development governance index with 10 functions and 42 sub-functions has been proposed to facilitate inter-country comparisons. Potential sources of data for estimating HDGI have been suggested. The Governance indices for individual sub-functions can aid policy-makers to establish the sources of weak health governance and subsequently develop appropriate interventions for ameliorating the situation.An Editorial in the Af
The Monetary Value of Disability-Adjusted-Life-Years Lost in the East African Community in 2015  [PDF]
Joses Muthuri Kirigia, Germano Mwiga Mwabu
Modern Economy (ME) , 2018, DOI: 10.4236/me.2018.97087
Abstract: The East African Community (EAC) member states (Burundi, Kenya, Rwanda, Tanzania and Uganda) incur annually a huge loss of disability-adjusted life years (DALY) from communicable and non-communicable diseases and injuries annually. This study estimated the monetary value of DALYs lost in the EAC in 2015 without and with UN the health Sustainable Development Goal 3. The monetary value of DALYs lost in the EAC was estimated by multiplying the estimated DALYs associated with different diseases by GDP per capita net of health expenditures. The 82,017,651 DALYs lost in EAC in 2015 had a monetary value of Int$ 203,843,476,166. About 58.2% resulted from Communicable, maternal, perinatal and nutritional conditions; 30.3% from non-communicable diseases (NCDs); and 11.5% from injuries. Burundi incurred 2.8% of the total monetary value of DALYs, Kenya 33.9%, Rwanda 4.2%, Tanzania 39.5%, and Uganda 19.6%. The EAC could save approximately 31% of the total monetary value of DALYs lost if SDG 3 targets are fully achieved. Therefore, EAC member states should invest adequately into strengthening of national health systems and other systems that address social determinants to ensure healthy lives and promotion of well-being for all people at all ages.
Health challenges in Africa and the way forward
Joses Kirigia, Saidou Barry
International Archives of Medicine , 2008, DOI: 10.1186/1755-7682-1-27
Abstract: Out of 58.03 million people who died globally in 2005, 10.9 million (18.8%) were from the WHO African Region [1]. Majority of deaths (64%) that occurred in the Region resulted from HIV/AIDS (19%), lower respiratory infections (10%), malaria (8%), diarrhoeal diseases (7%), cerebrovascular disease (4%), ischaemic heart disease (3%), tuberculosis (3%), measles (3%), low birth weight (2%), birth asphyxia and birth trauma (2%) and maternal conditions (2%). Even though effective public health interventions that could have prevented most of deaths exist, coverage is low due to weak and under-resourced health systems. Some of the weaknesses can be attributed to challenges related to leadership and governance; health workforce; medical products, vaccines and technologies; information; financing; and services delivery [2].Firstly, there are serious leadership and governance challenges that include weak public health leadership and management [3]; inadequate health-related legislations and their enforcement; limited community participation in planning, management and monitoring of health services; weak inter-sectoral action; horizontal and vertical inequities in health systems [4]; inefficiency in resource allocation and use [5]; and weak national health information and research systems [6].Secondly, extreme shortages of health workers exist in 57 countries of which 36 are in Africa [8]. The crisis has been exacerbated by inequities in workforce distribution and brain drain. Thus, the delivery of effective public health interventions to people in need is compromised particularly in remote rural areas.Thirdly, there is rampant corruption in medical products and technologies procurement systems, unreliable supply systems, unaffordable prices, irrational use, wide variance in quality and safety [2]. This has contributed to current situation where 50% the population in the Region lack of access to essential medicines [6].Fourthly, there is a dearth of information and communication
Pecuniary Value of Disability-Adjusted-Life-Years in the Arab Maghreb Union in 2015  [PDF]
Rosenabi Deborah Karimi Muthuri, Newton Gitonga Muthuri, Joses Muthuri Kirigia
Journal of Human Resource and Sustainability Studies (JHRSS) , 2018, DOI: 10.4236/jhrss.2018.64041
Abstract: This study bridges extant information gap on the pecuniary value of disability-adjusted-life-years (DALYs) lost in the Arab Maghreb Union (AMU). The DALYs lost in 2015 are converted into money using human capital (lost output) approach. The AMU total value of DALYs lost from all causes is the sum of each of the five country’s pecuniary value of DALYs (PVD) lost from all causes. The PVD associated with DALYs lost due to jth disease among persons of a specific age group is the product of the per capita non-health GDP in international dollars (Int$) and the total DALYs lost. The 27,175,610 DALYs lost in AMU in 2015 had a pecuniary value of Int$ 289,033,271,814, which is equivalent to 25.6% the sub-region’s 2015 GDP. The average pecuniary value per DALY lost was Int$ 10,636, which ranged from a minimum of Int$ 4226 in Mauritania to a maximum of Int$ 13,852 in Algeria. The pecuniary value of DALYs lost from all causes in the AMU sub-region annually is substantive.
Meru University of Science and Technology Research Ethics Review System: A SWOT Analysis  [PDF]
Joses Muthuri Kirigia, Rosenabi Deborah Karimi Muthuri, Newton Gitonga
Journal of Biosciences and Medicines (JBM) , 2018, DOI: 10.4236/jbm.2018.612003
Abstract: The objectives of this article are as follows: 1) to propose a university research ethics system framework, 2) to provide a brief anatomy of the Meru University of Science and Technology (MUST) Institutional Research Ethics Review Committee (MIRERC), 3) to perform a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis of MIRERC, and 4) to make recommendations for improving its performance. The 13-member multi-disciplinary MIRERC was established in April 2017 to provide effective ethical oversight of research undertaken by the University’s scholarly community. Strengths of the MUST research ethics review system include a functional MIRERC, a pertinent national law and ethical guidelines, an Innovation and Enterprise Centre that could house a dedicated MIRERC Secretariat, and a supportive University Management Board. The weaknesses include lack of graduate schools to assure scientific rigor of proposals before submission to the MIRERC, lack of research ethics training in most school’s curricula, absence of a dedicated MIRERC Secretariat, undergraduate research proposals being not ethically reviewed, dearth of faculty trained in research ethics, and lack of an operating budget for MIRERC work. The opportunities include existence of about 22 accredited Institutional Research Ethics Review Committees (IRERC) in Kenya, existence of international standards and operational guidance for ethics review, availability of guidelines and codes of best ethical practices in research, existence of a free automated platform called Research for Health Innovation Organizer (RHInnO) Ethics for managing the ethics review process, and availability of external resources for strengthening IRERCs. In order to improve the performance and sustainability of the MUST research ethics system, there is need to include research ethics training in all undergraduate and post-graduate curricula, create a dynamic database of potential research ethics reviewers, allocate a percentage of the annual MUST research budget for MIRERC operations, charge a graduated fee for proposal ethics review, require all students’ and faculties’ internal and external research proposals be cleared by the MIRERC, and use the RHInnO Ethics platform to manage the ethics review process.
Status of national health research systems in ten countries of the WHO African Region
Joses M Kirigia, Charles Wambebe
BMC Health Services Research , 2006, DOI: 10.1186/1472-6963-6-135
Abstract: The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward.A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country) bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet.The key findings were as follows: the response rate was 21.7% (10/46); three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS); two countries confirmed the existence of a functional national health research management forum (NHRMF); six countries had a functional ethical review committee (ERC); five countries had a scientific review committee (SRC); five countries reported the existence of health institutions with institutional review committees (IRC); two countries had a health research programme; and three countries had a national health research institute (NHRI) and a faculty of health sciences in the national university that conducted health research. Four out of the ten countries reported that they had a budget line for health research in the Ministry of Health budget document.Governments of countries of the African Region, with the support of development partners, private sector and civil society, urgently need to improve the research policy environment by developing health research policies, strategic plans, legislations, programmes and rolling plans with the involvement of all stakeholders, e.g., relev
Cost of mental and behavioural disorders in Kenya
Joses M Kirigia, Luis G Sambo
Annals of General Psychiatry , 2003, DOI: 10.1186/1475-2832-2-7
Abstract: Drawing information from various secondary sources, this study used standard cost-of-illness methods to estimate: (a) the direct costs, i.e. those borne by the health care system and the family in directly addressing the problem of MBD; and (b) the indirect costs, i.e. loss of productivity caused by MBD, which is borne by the individual, the family or the employer. The study was based on Kenyan public hospitals, either dedicated to care of MBD patients or with a MBD ward.The study revealed that: (i) in the financial year 1998/99, the Kenyan economy lost approximately US$13,350,840 due to institutionalized MBD patients; (ii) the total economic cost of MBD per admission was US$2,351; (iii) the unit cost of operating and organizing psychiatric services per admission was US$1,848; (iv) the out-of-pocket expenses borne by patients and their families per admission was US$51; and (v) the productivity loss per admission was US$453.There is an urgent need for research in all African countries to determine: national-level epidemiological burden of MBD, measured in terms of the prevalence, incidence, mortality, and, probably, the disability-adjusted life-years lost; and the economic burden of MBD, broken down by different productive and social sectors and occupations of patients and relatives."..mental health affects all spheres of human endeavour and that there is no health without mental health. .. Ministers (of Health at the 54th World Health Assembly) agreed that raising the level of awareness is the first priority. Policy-makers in government and civil society need to be sensitized about the huge and complex nature of the economic burden of MBD and the need for more resources to treat MBD."Senator the Hon. Phillip C. Goddard, Minister of Health, Barbados [1].The historical marginalization of mental health from mainstream health and welfare services in many countries has contributed to endemic stigmatization and discrimination of MBD people [2]. As a result, mental health
Africa's health: could the private sector accelerate the progress towards health MDGs?
Luis G Sambo, Joses M Kirigia
International Archives of Medicine , 2011, DOI: 10.1186/1755-7682-4-39
Abstract: Of the 752 total resolutions adopted by the WHO Regional Committee for Africa (RC) between years 1951 and 2010, 45 mention the role of the private sector. We argue that despite the rather limited role implied in RC resolutions, the private sector has a pivotal role in supporting the achievement of health MDGs, and articulating efforts with 2010-2015 priorities for WHO in the African Region: provision of normative and policy guidance as well as strengthening partnerships and harmonization; supporting the strengthening of health systems based on the Primary Health Care approach; putting the health of mothers and children first; accelerating actions on HIV/AIDS, malaria and tuberculosis; intensifying the prevention and control of communicable and noncommunicable diseases; and accelerating response to the determinants of health.The very high maternal and children mortality, very high burden of communicable and non-communicable diseases, health systems challenges, and inter-sectoral issues related to key determinants of health are too heavy for the public sector to address alone. Therefore, there is clear need for the private sector, given its breadth, scope and size, to play a more significant role in supporting governments, communities and partners to develop and implement national health policies and strategic plans; strengthen health systems capacities; and implement roadmaps for accelerating the attainment of health MDGs relating to maternal and child health, reducing disease burden, and promoting social determinants of health.In order for governments to further explore the potential benefits of the private sector towards improved performance of health systems, there is need for accurate evidence on the private sector capacity in areas of prevention, promotion, treatment and rehabilitation; dialogue and negotiation; clear definition of roles and responsibilities; and regulatory frameworks.The objectives of this article are to provide an overview of the state of publ
National health financing policy in Eritrea: a survey of preliminary considerations
Kirigia Joses,Zere Eyob,Akazili James
BMC International Health and Human Rights , 2012, DOI: 10.1186/1472-698x-12-16
Abstract: Background The 58th World Health Assembly and 56th WHO Regional Committee for Africa adopted resolutions urging Member States to ensure that health financing systems included a method for prepayment to foster financial risk sharing among the population and avoid catastrophic health-care expenditure. The Regional Committee asked countries to strengthen or develop comprehensive health financing policies. This paper presents the findings of a survey conducted among senior staff of selected Eritrean ministries and agencies to elicit views on some of the elements likely to be part of a national health financing policy. Methods This is a descriptive study. A questionnaire was prepared and sent to 19 senior staff (Directors) in the Ministry of Health, Labour Department, Civil Service Administration, Eritrean Confederation of Workers, National Insurance Corporation of Eritrea and Ministry of Local Government. The respondents were selected by the Ministry of Health as key informants. Results The key findings were as follows: the response rate was 84.2% (16/19); 37.5% (6/16) and 18.8% said that the vision of Eritrean National Health Financing Policy (NHFP) should include the phrases ‘equitable and accessible quality health services’ and ‘improve efficiency or reduce waste’ respectively; over 68% indicated that NHFP should include securing adequate funding, ensuring efficiency, ensuring equitable financial access, protection from financial catastrophe, and ensuring provider payment mechanisms create positive incentives to service providers; over 80% mentioned community participation, efficiency, transparency, country ownership, equity in access, and evidence-based decision making as core values of NHFP; over 62.5% confirmed that NHFP components should consist of stewardship (oversight), revenue collection, revenue pooling and risk management, resource allocation and purchasing of health services, health economics research, and development of human resources for health; over 68.8% indicated cost-sharing, taxation and social health insurance as preferred revenue collection mechanisms; and 68.75% indicated their preferred provider payment mechanism to be a global (lump sum) budget. Conclusion This study succeeded in gathering the preliminary views of senior staff of selected Eritrean ministries and agencies regarding the likely elements of the NHFP, i.e. the vision, objectives, components, provider payment mechanisms, and health financing agency and its governance. In addition to stakeholder surveys, it would be helpful to inform the development of the NHFP
Equity in health and healthcare in Malawi: analysis of trends
Eyob Zere, Matshidiso Moeti, Joses Kirigia, Takondwa Mwase, Edward Kataika
BMC Public Health , 2007, DOI: 10.1186/1471-2458-7-78
Abstract: This study attempts to assess trends in inequities in selected indicators of health status and health service utilization in Malawi using data from the Demographic and Health Surveys of 1992, 2000 and 2004.Data from Demographic and Health Surveys of 1992, 2000 and 2004 are analysed for inequities in health/healthcare using quintile ratios and concentration curves/indices.Overall, the findings indicate that in most of the selected indicators there are pro-rich inequities and that they have been widening during the period under consideration. Furthermore, vertical inequities are observed in the use of interventions (treatment of diarrhoea, ARI among under-five children), in that the non-poor who experience less burden from these diseases receive more of the treatment/interventions, whereas the poor who have a greater proportion of the disease burden use less of the interventions. It is also observed that the publicly provided services for some of the selected interventions (e.g. child delivery) benefit the non-poor more than the poor.The widening trend in inequities, in particular healthcare utilization for proven cost-effective interventions is likely to jeopardize the achievement of the Millennium Development Goals and other national and regional targets. To counteract the inequities it is recommended that coverage in poor communities be increased through appropriate targeting mechanisms and effective service delivery strategies. There is also a need for studies to identify which service delivery mechanisms are effective in the Malawian context.There has been increased attention to issues of equity in health and healthcare with the renewed commitment of governments and international organizations to improve the health status of the poor and marginalized [1,2]. Equity is one of the basic principles of the Primary Health Care approach [3] and features implicitly or explicitly in the health policies of most countries [4].Growing scientific evidence points to the pervas
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