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Cited by 63Public Health Policies and EducationHealthcare Systems and PracticesHealth Policy Implementation Science

Communicable disease control programmes and health systems: an analytical approach to sustainability

Shigayeva, Altynay, Coker, Richard J·2015·Health Policy and Planning
DOI 10.1093/heapol/czu005
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Abstract

There is renewed concern over the sustainability of disease control programmes, and re-emergence of policy recommendations to integrate programmes with general health systems. However, the conceptualization of this issue has remarkably received little critical attention. Additionally, the study of programmatic sustainability presents methodological challenges. In this article, we propose a conceptual framework to support analyses of sustainability of communicable disease programmes. Through this work, we also aim to clarify a link between notions of integration and sustainability. As a part of development of the conceptual framework, we conducted a systematic literature review of peer-reviewed literature on concepts, definitions, analytical approaches and empirical studies on sustainability in health systems. Identified conceptual proposals for analysis of sustainability in health systems lack an explicit conceptualization of what a health system is. Drawing upon theoretical concepts originating in sustainability sciences and our review here, we conceptualize a communicable disease programme as a component of a health system which is viewed as a complex adaptive system. We propose five programmatic characteristics that may explain a potential for sustainability: leadership, capacity, interactions (notions of integration), flexibility/adaptability and performance. Though integration of elements of a programme with other system components is important, its role in sustainability is context specific and difficult to predict. The proposed framework might serve as a basis for further empirical evaluations in understanding complex interplay between programmes and broader health systems in the development of sustainable responses to communicable diseases.

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  • Sustainability as a process rather than an outcome incorporates adaptation, learning and continuous development.

    “This concept of sustainability as a ‘process’ rather than an ‘outcome’, incorporates concepts of adaptation, learning and continuous development [15].”

    From Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare (2018) · cites this paper as [15]

  • Sustainability can be viewed as a change process that can be influenced by individuals throughout initiatives by continuing to develop and adapt in response to the needs of the system.

    “This lens allows sustainability to be viewed as a change process that can be influenced by individuals throughout initiatives by continuing to develop and adapt in response to the needs of the system [15–17].”

    From Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare (2018) · cites this paper as [15]

  • Some work has reviewed frameworks for sustainability in specific settings and programmes, but little has been done to comprehensively review available approaches for sustainability across healthcare settings.

    “Some work has been undertaken to review frameworks for sustainability in specific settings and programmes, but little has been done to comprehensively review available approaches for sustainability across healthcare settings [15, 18, 19].”

    From Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare (2018) · cites this paper as [15]

  • Many approaches highlighted the importance of the ability of an initiative to garner and maintain resources through stable sources.

    “Many approaches highlighted the importance of the ability of an initiative to garner and maintain resources [15, 27, 36–41] through stable sources [19, 36, 39, 42–45].”

    From Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare (2018) · cites this paper as [15]

  • Despite previous work finding that 'most frameworks proposed tend to be deterministic in nature where sustainability is viewed as an end goal', this review found that 66% of approaches reviewed saw sustainability as a process rather than an end state.

    “Despite previous work finding that ‘most frameworks proposed tend to be deterministic in nature where sustainability is viewed as an end goal’, we found that 66% of approaches we reviewed saw sustainability as a process rather than an end state [15].”

    From Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare (2018) · cites this paper as [15]

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Authors
Shigayeva, A., & Coker, R. J.
Affiliations
London School of Hygiene & Tropical Medicine (GB)
Corresponding author
Shigayeva, Altynay
Venue
Health Policy and Planning
Publisher
Oxford University Press (OUP)
Published
2014-02-21
Volume
30
Issue
3
Pages
368-385
ISSN
  • 0268-1080 (ISSN-L)
  • 1460-2237
DOI
10.1093/heapol/czu005
OpenAlex
W2150065284
Cited by
63
References
211
Citations by year
2025: 3 · 2024: 4 · 2023: 16 · 2022: 6 · 2021: 1 · 2020: 6 · 2019: 6 · 2018: 5 · 2017: 7 · 2016: 2 · 2015: 3 · 2014: 3
FWCI
0.85
Type
journal article
Language
en
Open access
closed
Locations
  • Health Policy and Planning (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Public Health Policies and Education
  • Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Practices
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
sustainability, health care system, program integration, complex adaptive systems, sustainability science, conceptual framework, leadership, capacity, flexibility, performance, health system resilience
MeSH terms
Communicable Disease Control, Delivery of Health Care, Government Programs, Humans, Leadership, Program Evaluation, Capacity Building

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