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Problem Political economy factors are important in determining the adoption and implementation of health policies. Yet these factors are often overlooked in the development of policies that have the potential to influence health. Approach Political economy analysis provides a way to take into consideration political and social realities, whether at the community, subnational, national, regional or global levels. We aim to demonstrate the value of political economy analysis and to promote its wider use in technical programmes of work. Local setting We provide examples from across a range of World Health Organization areas of work, including participatory governance, health financing, health taxes, malaria prevention and control, capacity-building and direct country support. Relevant changes Existing examples of how political economy analysis can be incorporated into technical support demonstrate the variability of this analytical approach, as well as its potential to support policy progress. Applying political economy analysis within the specified programmes of work has enabled more contextually relevant technical support to enhance the likelihood of advancing countries' health-related objectives. Lessons learnt Embedding political economy into technical work has many benefits, including: enhancing voice and participation in health policies; supporting the adoption and implementation feasibility of technically sound policies; and building capacity to incorporate and understand political factors that influence health-related priorities. Probleme Lesfacteurs llesa l'economie polltlquejouent un role crucial dans l'adoptlon et la mise en ceuvre de mesures sanitaires. Pourtant, ces facteurs sont souvent negllges lors de l'elaboration de politiques susceptibles d'avoir un Impact sur la sante. Approche Analyser l'economie politique represente un moyen de tenir compte des realites politiques et sociales au niveau communautaire, infranational, national, regional ou International. Nous voulons demontrer l'importance de l'analyse de l'economie politique et promouvolr son usage dans les programmes techniques de travail. Environnement local Nous donnons des exemples Issus d'une serie de domalnes traites par l'Organisation mondlale de la Sante, parmi lesquels la gouvernance participative, le financement de la sante, les taxes sanltalres, la prevention et la lutte contre la malaria, le renforcement des capacltes et l'appul direct aux pays. Changements significatifs Les exemples portant sur l'integration de l'analyse de l'economie politique dans l'appul technique illustrent la variabilite de cette approche analytique, mais aussi sa potentielle contribution aux progres politiques. Appliquer une analyse de l'economie politique a des programmes de travail specifiques a permls de fournir un soutien technique adapte au contexte, augmentant ainsi les chances d'avancement des pays vers la realisation des objectifs en matierede sante. Lecons tirees Incorporer l'economie politique dans le travail technique comporte de nombreux avantages: amelloration de la representation et de la participation dans le cadre des mesures sanitalres; mellieures possibilites d'adoption et de mise en ceuvre de politiques solides sur le plan technique; et enfin, renforcement des capacites afin de comprendre et d'inclure les facteurs politiques qui ont une influence sur les priorites relatives a la sante. Situacion Los factores de economia politica son Importantes para determinar la adopcion y aplicacion de las politicas sanitarias. Sin embargo, se suelen Ignorar estos factores cuando se elaboran politicas que pueden Influir en la salud. Enfoque El analisis de economia politica permite tener en cuenta las realidades politicas y sociales, ya sea a nivel local, subnaclonal, nacional, regional o mundial. El objetivo de este proyecto es demostrar el valor del analisis de la economia politica y promover su uso generalizado en los programas tecnicos de trabajo. Marco regional Se ofrecen ejemplos de diversas areas de trabajo de la Organizacion Mundial de la Salud, como la gobernanza participativa, la financiacion sanitaria, los Impuestos sanitarios, la prevencion y la contencion del paludismo, la creacion de capacidades y el apoyo directo a los paises. Cambios importantes Los ejemplos existentes de como se puede Incorporarei analisis de economia politica al apoyo tecnico demuestran la variabilidad de este enfoque analitico, asi como su potencial para apoyar el progreso de las politicas. La aplicacion del analisis de la economia politica en los programas de trabajo especificados ha permitido que el apoyo tecnico sea mas pertinente segun el contexto para aumentar la probabilidad de avanzar en los objetivos sanitarios de los paises. Lecciones aprendidas Integrar la economia politica en el trabajo tecnico tiene muchos beneficios, entre los que se Incluyen: potenciar las opiniones y la participacion en las politicas sanitarias; apoyar la adopcion y la viabilidad de la aplicacion de politicas tecnicamente solldas;y crear capacidad para Incorporar y comprender los factores politicos que Influyen en las prioridades sanitarias., Introduction As the coronavirus disease 2019 pandemic has demonstrated, policies that impact health and well-being are not only influenced by scientific evidence, but also by the political views and underlying [...]

BackgroundHealth workforce needs-based shortages and skill mix imbalances are significant health workforce challenges. Task shifting, defined as delegating tasks to existing or new cadres with either less training or narrowly tailored training, is a potential strategy to address these challenges. This study uses an economics perspective to review the skill mix literature to determine its strength of the evidence, identify gaps in the evidence, and to propose a research agenda.MethodsStudies primarily from low-income countries published between 2006 and September 2010 were found using Google Scholar and PubMed. Keywords included terms such as skill mix, task shifting, assistant medical officer, assistant clinical officer, assistant nurse, assistant pharmacist, and community health worker. Thirty-one studies were selected to analyze, based on the strength of evidence.ResultsFirst, the studies provide substantial evidence that task shifting is an important policy option to help alleviate workforce shortages and skill mix imbalances. For example, in Mozambique, surgically trained assistant medical officers, who were the key providers in district hospitals, produced similar patient outcomes at a significantly lower cost as compared to physician obstetricians and gynaecologists. Second, although task shifting is promising, it can present its own challenges. For example, a study analyzing task shifting in HIV/AIDS in sub-Saharan Africa noted quality and safety concerns, professional and institutional resistance, and the need to sustain motivation and performance. Third, most task shifting studies compare the results of the new cadre with the traditional cadre. Studies also need to compare the new cadre's results to the results from the care that would have been provided--if any care at all--had task shifting not occurred.ConclusionsTask shifting is a promising policy option to increase the productive efficiency of the delivery of health care services, increasing the number of services provided at a given quality and cost. Future studies should examine the development of new professional cadres that evolve with technology and country-specific labour markets. To strengthen the evidence, skill mix changes need to be evaluated with a rigorous research design to estimate the effect on patient health outcomes, quality of care, and costs.

The United Nations General Assembly adopted the Political Declaration of the High-Level Meeting on Universal Health Coverage (UHC) on 10 October 2019, marking the culmination of concerted efforts to bring [...]

Abstract Background Health workforce needs-based shortages and skill mix imbalances are significant health workforce challenges. Task shifting, defined as delegating tasks to existing or new cadres with either less training or narrowly tailored training, is a potential strategy to address these challenges. This study uses an economics perspective to review the skill mix literature to determine its strength of the evidence, identify gaps in the evidence, and to propose a research agenda. Methods Studies primarily from low-income countries published between 2006 and September 2010 were found using Google Scholar and PubMed. Keywords included terms such as skill mix, task shifting, assistant medical officer, assistant clinical officer, assistant nurse, assistant pharmacist, and community health worker. Thirty-one studies were selected to analyze, based on the strength of evidence. Results First, the studies provide substantial evidence that task shifting is an important policy option to help alleviate workforce shortages and skill mix imbalances. For example, in Mozambique, surgically trained assistant medical officers, who were the key providers in district hospitals, produced similar patient outcomes at a significantly lower cost as compared to physician obstetricians and gynaecologists. Second, although task shifting is promising, it can present its own challenges. For example, a study analyzing task shifting in HIV/AIDS in sub-Saharan Africa noted quality and safety concerns, professional and institutional resistance, and the need to sustain motivation and performance. Third, most task shifting studies compare the results of the new cadre with the traditional cadre. Studies also need to compare the new cadre's results to the results from the care that would have been provided--if any care at all--had task shifting not occurred. Conclusions Task shifting is a promising policy option to increase the productive efficiency of the delivery of health care services, increasing the number of services provided at a given quality and cost. Future studies should examine the development of new professional cadres that evolve with technology and country-specific labour markets. To strengthen the evidence, skill mix changes need to be evaluated with a rigorous research design to estimate the effect on patient health outcomes, quality of care, and costs.

Global and national initiatives focused on health systems strengthening, universal health coverage, health security, and resilience suffer when these terms are not well understood or believed to be different ways [...]