Showing papers by "Nicholas Mays published in 2014"
TL;DR: The Success Factors for Women's and Children's Health (SELF) studies as discussed by the authors investigated why some countries achieve faster progress than other comparable countries in the Millennium Development Goals (MDGs) by using statistical and econometric analyses of data from 144 low and middle-income countries (LMICs).
Abstract: Reducing maternal and child mortality is a priority in the Millennium Development Goals (MDGs), and will likely remain so after 2015. Evidence exists on the investments, interventions and enabling policies required. Less is understood about why some countries achieve faster progress than other comparable countries. The Success Factors for Women’s and Children’s Health studies sought to address this knowledge gap using statistical and econometric analyses of data from 144 low- and middle-income countries (LMICs) over 20 years; Boolean, qualitative comparative analysis; a literature review; and country-specific reviews in 10 fast-track countries for MDGs 4 and 5a. There is no standard formula – fast-track countries deploy tailored strategies and adapt quickly to change. However, fast-track countries share some effective approaches in addressing three main areas to reduce maternal and child mortality. First, these countries engage multiple sectors to address crucial health determinants. Around half the reduction in child mortality in LMICs since 1990 is the result of health sector investments, the other half is attributed to investments made in sectors outside health. Second, these countries use strategies to mobilize partners across society, using timely, robust evidence for decision-making and accountability and a triple planning approach to consider immediate needs, long-term vision and adaptation to change. Third, the countries establish guiding principles that orient progress, align stakeholder action and achieve results over time. This evidence synthesis contributes to global learning on accelerating improvements in women’s and children’s health towards 2015 and beyond.
163 citations
TL;DR: The success factors for women's and children's health (success factors) studies as mentioned in this paper were developed to understand what works to support countries' progress towards the Millennium Development Goals (MDGs) and to inform the post-2015 goals and strategies under preparation.
Abstract: Introduction Worldwide, accelerated progress is required to achieve Millennium Development Goals (MDGs) 4 (reduce child mortality) and 5 (improve maternal health) as highlighted in the United Nations Secretary-General's Global Strategy for Women's and Children's Health. (1) There have been substantial achievements from 1990 (the baseline for the MDGs) to date. Child and maternal deaths decreased globally by around 50%, and contraceptive prevalence increased from 55% to 63%. (2-4) There is consensus on evidence-based, cost-effective investments and interventions (5,6) and on enabling health and multisectoral policies. (7) Despite these advances, every year 6.6 million children die before five years of age (44% as newborns) and 289 000 maternal deaths occur, most from preventable causes. (2-4) Progress varies widely across countries, even where levels of income are similar. (8) There is a need for evidence on why some low- and middle-income countries (LMICs) do better than others in preventing maternal and child deaths and on the strategies they use to accelerate progress. (8,9) This knowledge gap prompted discussions at the Partnership for Maternal, Newborn & Child Health Partners' Forum in 2010, leading to a three-year multidisciplinary, multicountry series of studies on Success Factors for Women's and Children's Health (hereafter referred to as the Success Factors studies). (10) The Success Factors studies were supported by the Partnership for Maternal, Newborn & Child Health, the World Health Organization (WHO), the World Bank and the Alliance for Health Policy and Systems Research, working closely with ministries of health, academic institutions and other partners. (10) The studies sought to understand what works to support countries' progress towards the MDGs and to inform the post-2015 goals and strategies under preparation. Methods Analytical framework The analytical framework for the Success Factors studies (Box 1) builds on the UN Millennium Project's "clusters of public investments and policies" (11) and WHO's "health systems building blocks". (12) We used literature reviews and expert consultations to identify over 250 related variables to develop the database for these studies. (13) Countries included The statistical and econometric analyses included all 144 countries that the World Bank designated as LMICs in 1990. For the in-depth country reviews, we selected 10 of the 75 "Countdown to 2015" high-mortality burden countries: (8) Bangladesh, Cambodia, China, Egypt, Ethiopia, Lao People's Democratic Republic, Nepal, Peru, Rwanda and Viet Nam. We refer to these countries as "fast-track" because they were on track in 2012 to achieve both MDGs 4 and 5 ahead of comparable countries. (Other Countdown countries such as Liberia and the Niger are achieving fast-track progress to reduce child mortality. If we consider all 144 LMICs, rather than only the 75 Countdown countries, additional fast-track countries for reducing both maternal and child mortality include the Maldives and Turkey). Research methods The Success Factors studies teams developed five primary technical papers based on: (i) quantitative mapping of trends; (14) (ii) econometric modelling; (15) (iii) Boolean, Qualitative Comparative Analysis; (16) (iv) literature review with narrative evidence synthesis; (17) and (v) country-specific literature and data reviews in 10 fast-track countries. (18) As a following step, ministries of health will convene multistakeholder policy review meetings in the 10 selected fast-track countries to document milestones on each country's pathway to improving women's and children's health. Each country will subsequently publish a policy report. (19) Box 1. Analytical framework for the Success Factors for Women's and Children's Health study series Independent variables Health sector: investments in health systems with universal access to services * Service delivery (e. …
75 citations
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11 Apr 2014
TL;DR: In this paper, the authors present a longitudinal analysis of the health systems of the UK: How do they compare? which is based on a previous report published by the Nuffield Trust and revised in 2011.
Abstract: Since political devolution in 1999, there has been increasing policy divergence between the health systems of the four countries of the United Kingdom (UK). This report attempts to update earlier comparisons of the publicly financed health systems of England, Scotland, Wales and Northern Ireland in terms of funding, inputs and performance before and since devolution. It also includes comparisons with the North East of England, which has been chosen as a better comparator with the three devolved nations than England as a whole. The four health systems of the UK: How do they compare? is authored by six leading health academics: Professor Gwyn Bevan, Marina Karanikolos, Jo Exley, Ellen Nolte, Sheelah Connolly and Professor Nicholas Mays. The team was led by Professor Nicholas Mays of the London School of Hygiene and Tropical Medicine. The research is the only longitudinal analysis of its kind, building on a previous report published by the Nuffield Trust in 2010 and revised in 2011. That report presented three snapshots before and after devolution, with the most recent data being for 2006/07. This latest report gives trends over time for a wider range of performance indicators from the late 1990s to 2011/12, or 2012/13 where data were available. The report is accompanied two appendices, which include all the data and reference material. Further analysis of the history of the devolution settlement and the health policies of the four countries will be included in an analysis by Professor Gwyn Bevan, to be published later in 2014.
68 citations
TL;DR: New services generated a more complex system where new and existing providers delivered overlapping services and the new provision did not induce substitution and was likely to have increased overall demand, suggesting initiatives to improve access and convenience at lower marginal costs than developing new forms of provision.
40 citations
01 Apr 2014
TL;DR: This report attempts to update earlier comparisons of the publicly financed health systems of England, Scotland, Wales and Northern Ireland in terms of funding, inputs and performance before and since devolution.
Abstract: Since political devolution in 1999, there has been increasing policy divergence between the health systems of the four countries of the United Kingdom (UK). This report attempts to update earlier comparisons of the publicly financed health systems of England, Scotland, Wales and Northern Ireland in terms of funding, inputs and performance before and since devolution. It also includes comparisons with the North East of England, which has been chosen as a better comparator with the three devolved nations than England as a whole. The four health systems of the UK: How do they compare? is authored by six leading health academics: Professor Gwyn Bevan, Marina Karanikolos, Jo Exley, Ellen Nolte, Sheelah Connolly and Professor Nicholas Mays. The team was led by Professor Nicholas Mays of the London School of Hygiene and Tropical Medicine. The research is the only longitudinal analysis of its kind, building on a previous report published by the Nuffield Trust in 2010 and revised in 2011. That report presented three snapshots before and after devolution, with the most recent data being for 2006/07. This latest report gives trends over time for a wider range of performance indicators from the late 1990s to 2011/12, or 2012/13 where data were available. The report is accompanied two appendices, which include all the data and reference material. Further analysis of the history of the devolution settlement and the health policies of the four countries will be included in an analysis by Professor Gwyn Bevan, to be published later in 2014.
25 citations
TL;DR: Drawing on experience as an applied health services researcher and policy adviser in government, it is attempted to stimulate reflection on how can the timing of this phenomenon be explained; how realistic and helpful is it; and where does it leave the contribution of evaluation in policy.
Abstract: There has been a recent upsurge of advocacy from trialists and policy ‘modernisers’ for far more use of RCTs as the basis for health and wider public policy. This is exemplified by the UK Cabinet Office’s report ‘Test, Learn, Adapt’ (2012). Mainstream policy makers are now being told that they should make policy by experimenting like scientists. Drawing on experience as an applied health services researcher and policy adviser in government, I will attempt to stimulate reflection on the following questions: how can we explain the timing of this phenomenon; how realistic and helpful is it; and where does it leave the contribution of evaluation in policy?
14 citations
TL;DR: The analysis of the formulation of the English NHS Plan 2000 suggests that the Asymmetric Power Model better describes the reality of NHS policy making under New Labour than the Differentiated Polity Model.
Abstract: Research Highlights and AbstractThe article investigates which of two competing accounts of contemporary British policy making better captures the nature of policy making during episodes of major r...
12 citations
01 Jan 2014
TL;DR: The aim of the evaluation was to describe the uptake of the pilot scheme, and give an early indication of its potential costs and benefits for participating practices and patients over a 12-month period, recognising that it would not be possible to quantify Costs and benefits definitively over such a short time.
Abstract: The choice of general practice pilot began in April 2012 for 12 months and allowed patients to choose to seek care from any volunteer general practice in four volunteer Primary Care Trust (PCT) areas of the country (Westminster, Salford, Manchester and Nottingham City) without being restricted by practice boundaries. Patients could either register with a pilot practice as an out of area (OoA) patient, or be seen as a ‘day patient’, while remaining registered with their original practice. The aim of the evaluation was to describe the uptake of the pilot scheme, and give an early indication of its potential costs and benefits for participating practices and patients over a 12-month period, recognising that it would not be possible to quantify costs and benefits definitively over such a short time.
7 citations
TL;DR: The likely impact of this policy change to widen patient choice of general practitioner to improve access through the voluntary removal of practice boundaries in the English NHS is discussed, using evidence from the pilot evaluation.
6 citations
01 Jan 2014
TL;DR: This report is the first from the independent evaluation of the ‘trailblazers’ and is based on a scoping study carried out over the summer and autumn of 2013 consisting of a literature review, documentary analysis, interviews and collection of descriptive data from trailblazer on their schemes for DPs.
Abstract: This report is the first from the independent evaluation of the ‘trailblazers’. It is based on a scoping study carried out over the summer and autumn of 2013 consisting of a literature review, documentary analysis, interviews (June-September), collation of routine data and collection of descriptive data from trailblazers on their schemes for DPs.
3 citations
TL;DR: In Canada, different medical end-of-life practices, such as treatment withdrawal, use of medication justified by a single court decision, are different.
Abstract: In their CMAJ editorial, Flegel and Fletcher[1][1] call for a national dialogue on end-of-life care, arguing that policy change should not be the result of a single court decision.[1][1] In Canada, different medical end-of-life practices, such as treatment withdrawal, use of medication justified by
DOI•
01 Jan 2014
TL;DR: The choice of general practice pilot as mentioned in this paper allowed patients to choose to seek care from any volunteer general practice in four volunteer Primary Care Trust (PCT) areas of the country (Westminster, Salford, Manchester and Nottingham City) without being restricted by practice boundaries.
Abstract: The choice of general practice pilot began in April 2012 for 12 months and allowed patients to choose to seek care from any volunteer general practice in four volunteer Primary Care Trust (PCT) areas of the country (Westminster, Salford, Manchester and Nottingham City) without being restricted by practice boundaries. Patients could either register with a pilot practice as an out of area (OoA) patient, or be seen as a ‘day patient’, while remaining registered with their original practice. The aim of the evaluation was to describe the uptake of the pilot scheme, and give an early indication of its potential costs and benefits for participating practices and patients over a 12-month period, recognising that it would not be possible to quantify costs and benefits definitively over such a short time.
TL;DR: In this article, the authors argue that women need to take lessons from the anti-abortion lobby of the 1970s and get organised now, with the emergence of the Conservative Party in 2011, and National's explicitly expressed interest in seeing Conservative Party representation in Parliament from 2014.
Abstract: terms of cohesive interest representation – might best explain the limited progress of the 1970s and 1980s. More recently, the declining power of the Catholic Church and the recent swathe of liberal legislation allowing gay marriage, decriminalising prostitution and removing section 59 of the Crimes Act suggest that McCulloch’s concluding call to arms, and to remain vigilant, may be overstated. Yet, with the emergence of the Conservative Party in 2011, and National’s explicitly expressed interest in seeing Conservative Party representation in Parliament from 2014, perhaps feminists need to take lessons from the anti-abortion lobby of the 1970s and get organised now.
TL;DR: This work examined the extent to which the two generic health- related quality of life (HRQL) measures recommended for use in adult, general critical care - the SF-36 and EQ-5D - captured survivors' HRQL, which is important in assessing the effectiveness of critical care.
Abstract: We examined the extent to which the two generic health- related quality of life (HRQL) measures recommended for use in adult, general critical care [1] - the SF-36 and EQ-5D - captured survivors' HRQL, which is important in assessing the effectiveness of critical care. Unlike other fields of healthcare that employ both generic and specific HRQL measures, most recent studies in critical care have used only generic measures, despite uncertainty as to their appropriateness.