Sarkar Danya, Murphy Hillary, Fisseha Teemar, Koroma Aminata S, Hodges Mary H, Adero Nancy, Ngalombi Sarah, Nabakooza Jane, Wun Jolene, Namaste Sorrel M L
Strengthening Partnerships, Results, and Innovation in Nutrition Globally (SPRING) project, JSI Research and Training Institute, Inc., Arlington, Virginia, USA.
Directorate of Food and Nutrition, Ministry of Health and Sanitation, Freetown, Sierra Leone.
Int J Health Plann Manage. 2018 Oct;33(4):1024-1044. doi: 10.1002/hpm.2557. Epub 2018 Jul 3.
Anemia is a significant global health problem, and progress to reduce it has been slow. A multi-sectoral, context-specific, and country-led approach is recommended to effectively address anemia, but there is limited documentation of how this has worked in practice. We present key findings and lessons learned from Sierra Leone and Uganda's experiences establishing national-level anemia coordination platforms. A longitudinal collective case study methodology was used, with in-depth interviews of National Anemia Working Group members in both countries; data was analyzed to distill the salient lessons learned across countries. Similar factors were identified in the 2 countries. Setting the agenda was an important first step, accomplished by using country-specific anemia-related data and obtaining multi-sectoral commitment. Establishment of a cohesive coordination structure provided an effective platform to prioritize and align anemia activities. Strong, committed leadership and representation of diverse stakeholders was essential to maintain the legitimacy of anemia efforts. The main barriers to the policy-making process included misalignment of sectoral mandates, differences in work cultures, as well as competing priorities and increased staff workload. Sierra Leone and Uganda's experiences contribute to the global evidence base for anemia coordination and planning at the national level, particularly around linking health and non-health sectors and developing multi-sectoral platforms. It remains to be seen how and to what extent resulting policies in Sierra Leone and Uganda will translate to implementation.
贫血是一个重大的全球健康问题，且减少贫血的进展一直缓慢。建议采用多部门、因地制宜且由国家主导的方法来有效应对贫血问题，但关于这种方法在实际中如何发挥作用的记录有限。我们展示了从塞拉利昂和乌干达建立国家级贫血协调平台的经验中得出的关键发现和经验教训。采用了纵向集体案例研究方法，对两国的国家贫血工作组成员进行了深入访谈；对数据进行分析以提炼出各国的显著经验教训。在这两个国家发现了相似的因素。设定议程是重要的第一步，通过使用特定国家与贫血相关的数据并获得多部门承诺来实现。建立一个有凝聚力的协调结构为确定贫血活动的优先次序和使其保持一致提供了一个有效平台。强有力的、有决心的领导以及不同利益相关者的参与对于维持贫血防治工作的合理性至关重要。决策过程的主要障碍包括部门职责不一致、工作文化差异以及相互竞争的优先事项和工作人员工作量增加。塞拉利昂和乌干达的经验为国家层面贫血协调和规划的全球证据库做出了贡献，特别是在将卫生部门与非卫生部门联系起来以及建立多部门平台方面。塞拉利昂和乌干达最终的政策将如何以及在多大程度上转化为实际行动还有待观察。
