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Despite the consensus on the importance of evidence based health information for decision28 making and health policy formulation, quality information is not always available. This situation led the WHO in 2009 to recommend the establishment of an African Health Observatory and National Health Observatories. The WHO recommended 4 phases approach for the establishment of National Health Observatories was used in Cameroon: the preliminary phase, start-up, strengthening and full operation. Despite a non-optimal institutional positioning, the Cameroon’s Health Observatory is in the strengthening phase and contributes to evidence-based decision making in the health system. A strong political commitment is fundamental from the beginning of the project. The establishment of National Health Observatories calls for genuine national ownership, both of the process as a whole and of the tool itself. WHO should regularly assess the progress made in the establishment of National Health Observatories in different countries and provide feedback to them. A step-by-step approach, jointly validated by national stakeholders in a roll-out plan, would be more appropriate for the sustainability of the work of National Health Observatories.

Mixed methods were used with various data sources to describe organisation and delivery of maternity care in Maputo city, Mozambique in early 2010s and to compare the plans with the service provision in practice. In the public health sector, maternity care was organised to be area based and hierarchical with a planned referral system. The provision of basic and emergency maternity care was publicly funded, largely dependent of donor funds, and free of charge for users. Even though Maputo City was better resourced than the rest of the country, there was a large lack of health professionals. Women’s choices and self-referrals, even to higher levels of care, were common, which broke the plans of areas responsibility, gate keeping and care by medical needs. Private services for maternity care had emerged for those who were able to pay, leading to dual practices of health professionals and shortage of care providers in the public system at odd hours. Information of maternity care was aggregate and poorly stored. The gap between “planned” services delivery and “practice” in a real-life requires overall health system strengthening to improve efficiency and effectiveness of health services delivery.

In India, the election of a new government in 2014 with a massive mandate on the agenda of ‘change’ set in motion the process of drafting new policies in many sectors. A new health policy was also envisaged. Further impetus was provided by the emerging challenges, particularly those pertaining to high out of pocket expenditure and catastrophic expenditure on health. At the same time, global opportunities such as the adoption of Sustainable Development Goals combined with local positives such as the robust growth of healthcare industry in India and better fiscal capacity of the government also drove this ambition. The new National Health Policy 2017 is now adopted by the country and has been driven by the spirit of ‘cooperative governance’ and ‘participatory approach’. This article details these background processes involved in the development of National Health Policy 2017 for India. [ABSTRACT FROM AUTHOR]

Despite the consensus on the importance of evidence based health information for decision28 making and health policy formulation, quality information is not always available. This situation led the WHO in 2009 to recommend the establishment of an African Health Observatory and National Health Observatories. The WHO recommended 4 phases approach for the establishment of National Health Observatories was used in Cameroon: the preliminary phase, start-up, strengthening and full operation. Despite a non-optimal institutional positioning, the Cameroon's Health Observatory is in the strengthening phase and contributes to evidence-based decision making in the health system. A strong political commitment is fundamental from the beginning of the project. The establishment of National Health Observatories calls for genuine national ownership, both of the process as a whole and of the tool itself. WHO should regularly assess the progress made in the establishment of National Health Observatories in different countries and provide feedback to them. A step-by-step approach, jointly validated by national stakeholders in a roll-out plan, would be more appropriate for the sustainability of the work of National Health Observatories., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Published by Elsevier B.V.)

Health sector strategic plans are health policies outlining health service delivery in low- and middle- income countries, guiding health sectors to meet health needs while maximizing resources. However, little research has explored the formulation of these plans. This study utilized qualitative methods to explore the formulation of Malawi's Health Sector Strategic Plan II, including processes utilized, actors involved, important contextual factors and the use of evidence-based decision-making. Thirteen semi-structured key informant interviews with health policy actors were conducted to explore perceptions and experiences of formulating the policy. Data analysis used an inductive-deductive approach and interpretation of the data was guided by an adapted version of the Walt and Gilson Health Policy Triangle. Our results indicate that HSSP II formulation was complex and inclusive but that the Ministry of Health may have given up ownership of the formulation process to development partners to ensure their continued involvement. Disagreements between actors centered around inclusion of critical services in the Essential Health Package and selection of performance-based financing as purchasing strategy. Resource constraints and the Cashgate Scandal are critical contextual elements influencing the formulation and content of the policy. Evidence-based decision-making contributed to the plan's development despite respondents' divergent opinions regarding evidence availability, quality and the weight that evidence carried. The study raises questions regarding the roles of policy actors during health policy formulation, the inclusivity of health policy processes and their potential influence on government ownership of health policy, as well as the use of evidence in developing health sector strategic plans., (© 2020 John Wiley & Sons Ltd.)

Mixed methods were used with various data sources to describe organisation and delivery of maternity care in Maputo city, Mozambique in early 2010s and to compare the plans with the service provision in practice. In the public health sector, maternity care was organised to be area based and hierarchical with a planned referral system. The provision of basic and emergency maternity care was publicly funded, largely dependent of donor funds, and free of charge for users. Even though Maputo City was better resourced than the rest of the country, there was a large lack of health professionals. Women’s choices and self-referrals, even to higher levels of care, were common, which broke the plans of areas responsibility, gate keeping and care by medical needs. Private services for maternity care had emerged for those who were able to pay, leading to dual practices of health professionals and shortage of care providers in the public system at odd hours. Information of maternity care was aggregate and poorly stored. The gap between “planned” services delivery and “practice” in a real-life requires overall health system strengthening to improve efficiency and effectiveness of health services delivery. [ABSTRACT FROM AUTHOR]