| | | HEALTH POLICY AND SYSTEMS | | | | Heartfile has been focusing on a number of areas in Health Systems and Policy Research in order to strengthen the evidence base of health reform, assist with institutional restructuring, help in bridging gaps in information systems and mainstream chronic diseases into national public health planning. In addition to its focus on Pakistan, Heartfile contributes to increasing the knowledge base relevant to health systems in the developing countries. Individual research domains are highlighted in the following areas: | | | | | | | | | | Health systems reform | | | - Establishing a country framework for health systems performance assessment (initiated in 2009).
Funding: WHO-led platform to Strengthen Monitoring and Analysis of Country Health Systems - Developing an IT-supported demand side health financing tool,
 which can enable efficient, timely and well-targeted cash transfers in order to protect the poor against catastrophic spending on health, and to establish a seed Health Equity Fund as a means of resourcing cash transfers (initiated in 2008). Funding: Rockefeller Foundation - Background research for the publication entitled 'Choked Pipes: Reforming Pakistan's Mixed Health System'. The publication charts a roadmap for health reform in Pakistan.
- Presenting the first consolidated review of health systems constraints in Pakistan in a document entitled 'Health Systems in Pakistan—a Way Forward: the Gateway Paper'. This strategy was recognized as a blueprint for health reform and provided the basis for formulation of a new national policy for Pakistan. Pro bono time contribution Sania Nishtar
- Conducting a series of national meetings—the Post-Gateway Roundtables to develop consensus on the strategy proposed by the Gateway Paper. (2005-07) Funding support for the meetings was provided by: Department of International Development UK and the World Bank
- Developing drafts of the national and provincial (NWFP) health policies of Pakistan under Memoranda of Understanding (MoU) with the Federal Ministry of Health, and with the provincial government of NWFP, both of whom expressed a desire to develop a health policy based on the Gateway Paper's approach to health systems. Time contribution Sania Nishtar
- Conducted an assessment of corruption in health service delivery. Funding: Asian Development Bank-supported Partnership for Transparency Fund (PTF)
- Research in the area of priority setting for health systems research; the study aimed at the development of a locally suited priority-setting model. Funding: Global Forum for Health Research, Geneva
- Research in the domain of communications. The intervention campaigns used as part of these projects went beyond the public service announcement approach, utilizing lessons from behavioural research capitalizing on the strengths of social marketing. Funding: Canadian International Development Agency. Details of the campaigns can be accessed
| | | | Health information systems | | | | | | | | Institutional reorganization | | | | Pakistan is one of the few countries in the world where the ministries of Health and Population exist as two separate institutional entities; health and population have shared agenda and despite several attempts in the past at the highest level of government, efforts to integrate the two ministries have not been fruitful. Heartfile conducted a study to analyze if merger is a viable option and explore a way forward to bridge the current population-health institutional disconnect. A number of consultations were organized as part of the analytical process. The final report has been published in a special supplement of the JPMA its September 2009 issues and can be downloaded. 
Funding: David and Lucile Packard Foundation. | | | | Mainstreaming chronic diseases into the health system | | | | Heartfile is recognized for its pioneering contribution in the area of integrating non-communicable disease (NCD) prevention, control and health promotion into health systems planning in Pakistan. In the initial states of its development, Heartfile used innovative approaches of advocacy, leveraging social marketing and the use of media. This and other advocacy approaches enabled it to convince the government of the need for a public health programme on NCDs in Pakistan. Subsequently, Heartfile became part of a tripartite public-private partnership involving the Ministry of Health, Government of Pakistan, and the World Health Organization for development and implementation of a National Action Plan for Prevention and Control of Non-Communicable Diseases and Health Promotion in Pakistan (NAP-NCD). Details about the terms of this agreement, launching of the initiative, planning meetings leading to its development and the release of the NAP-NCD are posted online. Heartfile also took a lead role in helping to initiate the process of implementation of this plan on a pro bono basis; various stages of implementation of the pilot can be viewed. Heartfile's current objective is to institutionalize this programme in the Ministry of Health The NAP-NCD can also be downloaded In addition to its role in institutionalizing the national action plan on NCDs, Heartfile also - Established and evaluated the Heartfile-Lodhran CVD Prevention Project, a community demonstration pilot, which aimed to develop sustainable and low-resource-setting-sensitive strategies for prevention of chronic disease. Funding: Department of International Development, UK (2001-2004). End of project evaluation: click to view
- Established and evaluated the Heartfile-JC Project, a pilot, which aimed to develop an approach to integrate chronic disease prevention into the work-plan of health providers in the private sector. Funding: European Union-funded Trust for Voluntary Organizations.
- Heartfile was the principal investigator in Pakistan for the WHO PREMISE Study, a global study aimed at developing models for Prevention of Recurrences of Myocardial Infarction and Stroke and was represented on the Technical Committee of the study. Funding and Collaboration: WHO Cardiovascular Disease Unit, Geneva.
- Heartfile was the principal investigator in Pakistan for the WHO Risk Management Package, an international study aimed at testing the suitability of low-resource-setting-sensitive tools for secondary prevention of cardiovascular diseases. Funding and collaboration: WHO Cardiovascular Disease Unit, Geneva. End of project reporting available. View publications:
- Principal investigator for the Riskcorn Study: the first case control study to determine risk factors for coronary heart disease in Pakistanis. Collaboration: Guys and St. Thomas', London. Funding: Pakistan Medical Research Council and St Thomas' Hospital, London. View publications:
- Investigators in Pakistan for the INTERHEART study, a global study of risk factors in acute myocardial infarction; conducted by McMaster University, Canada.
- Heartfile was the principal investigator in Pakistan for the WHO Global [price of chronic disease medicines] Drug Survey, an international study to assess barriers to the use of medicines for secondary prevention of chronic disease. Funding and collaboration: WHO Cardiovascular Disease Unit, Geneva. View publications:
|
|
