Studies from University of Cape Town Update Current Data on Health Policy and Planning (How does power shape District Health Management Team responsiveness to public feedback in Low-and-Middle Income Countries? An interpretive synthesis): Health and Medicine – Health Policy and Planning

2022 DEC 27 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Research findings on health policy and planning are discussed in a new report. According to news originating from Cape Town, South Africa, by NewsRx correspondents, research stated, “Responsiveness is a core element of WHO’s health system framework, considered important in ensuring inclusive and accountable health systems. System-wide responsiveness requires system-wide action, and District Health Management Teams (DHMTs) play critical governance roles in many health systems.”

Financial supporters for this research include Alliance For Health Policy And Systems Research.

Our news editors obtained a quote from the research from University of Cape Town: “However, there is little evidence on how DHMTs enhance health system responsiveness. We conducted this interpretive literature review to understand how DHMTs receive and respond to public feedback, and how power influences these processes. A better understanding of power dynamics could strengthen responsiveness and improve health system performance. Our interpretive synthesis drew on English language articles published between 2000 and 2021. Our search in Pubmed, Google Scholar, and Scopus combined terms related to responsiveness (feedback, accountability) and DHMTs (district health manager) yielding 703 articles. We retained 21 articles after screening. We applied Gaventa’s power cube and Long’s actor interface frameworks to synthesise insights about power. Our analysis identified complex power practices across a range of interfaces involving the public, health system, and political actors. Power dynamics were rooted in social and organisational power relationships, personal characteristics (interests, attitudes, previous experiences), and worldviews (values and beliefs). DHMTs’ exercise of visible power sometimes supported responsiveness, however, they were undermined by the invisible power of public-sector bureaucracy that shaped generation of responses. Invisible power, manifesting in the sub-conscious influence of historical marginalisation, patriarchal norms, and poverty, hindered vulnerable groups from providing feedback.”

According to the news editors, the research concluded: “We also identified hidden power as influencing what feedback DHMTs received, and from whom. Our work highlights the influence of social norms, structures, and discrimination on power distribution among actors interacting with, and within, the DHMT. Recognising and building on the varied lifeworlds of actors involved in receiving and responding to public feedback, while paying attention to the broader context in which the lifeworlds are embedded has the potential to strengthen responsiveness.”

For more information on this research see: How does power shape District Health Management Team responsiveness to public feedback in Low-and-Middle Income Countries? An interpretive synthesis. Health Policy and Planning, 2022. The publisher for Health Policy and Planning is Oxford University Press (OUP).

A free version of this journal article is available at https://doi.org/10.1093/heapol/czac105.

Our news journalists report that additional information may be obtained by contacting Eleanor Whyle, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. Additional authors for this research include Nancy Kagwanja, Sassy Molyneux, Benjamin Tsofa, Lucy Gilson.

ORCID is an identifier for authors and includes bibliographic information. The following is ORCID information for the authors of this research: Nancy Kagwanja (http://orcid.org/0000-0002-4411-4961), Lucy Gilson (http://orcid.org/0000-0002-2775-7703).

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