Kaspar Wyss

• Professor
• Project leader at Swiss Tropical and Public Health Institute

Introduction: In Indian public health system, adherence to Integrated Management of Childhood Illness (IMNCI) guidelines is low due to inadequate capacity building, high workload and shortage of healthcare providers (HCPs). Objective was to explore barriers and enablers experienced by HCPs using a digital clinical decision support algorithm (CDSA)...

Background Acute illnesses are leading causes of death among children under-five, who often receive antibiotics unnecessarily, contributing to antimicrobial resistance. Pulse oximetry and digital Clinical Decision Support Algorithms (CDSAs) can strengthen the detection and management of severe childhood illnesses, and support antibiotic stewardship...

Background Digital clinical decision support systems (CDSS) enhance the quality of primary healthcare service delivery for vulnerable populations in resource-limited settings. This improvement occurs by strengthening healthcare providers’ clinical skills and enabling them to operate more independently while adhering to standard treatment guidelines...

Background Suicide prevention requires evidence-based measures at all prevention levels, embedded in coordinated and sustainable efforts. This policy brief aims to promote the long-term integration of project-based suicide prevention initiatives into the health system. We identify key facilitators and barriers to project sustainability and provide...

CONTEXT AND GOAL: This research addresses the issue of suicide and attempted suicide, which have a significant impact on global premature mortality and disability. Particularly noteworthy is the prevalence among adolescents, in whom suicide ranks among the top four causes of death according to the World Health Organization (WHO). In Switzerland, su...

Providing basic health services to nomadic populations is challenging mainly because of their mobility affecting geographical access to essential services but also due to their particular cultural habits and beliefs, influencing health intervention acceptance. The strategy of joint human and animal health campaigns applied in Chad for over 30 years...

Background Human resources are a key determinant for the quality of healthcare and health outcomes. Several human resource management approaches or practices have been proposed and implemented to better understand and address health workers’ challenges with mixed results particularly in low- and middle-income countries (LMICs). The aim of this fram...

Background Supporting individuals in managing their suicidality can prevent suicidal behavior. This study evaluated the suicide prevention project SERO, which was launched in Central Switzerland in 2021. SERO comprises four components: the suicide risk assessment technique PRISM-S, a personal safety plan, mental health first aid courses for relativ...

Background: With the DSM-5 revision, Somatic Symptom Disorder (SSD) no longer necessitates the medical unexplainability of symptoms, focusing instead on psychobehavioral criteria. This study is part of the “SomPsyNet” project that targets patients from SOMatic acute hospitals and aims to prevent PSYchosocial distress consequences in their course of...

Background Suicide prevention requires diverse, integrated, and evidence-based measures. Comprehensive evaluation of interventions and reliable suicide data are crucial for guiding policy-making and advancing suicide prevention efforts. This study aimed to analyze current issues and gaps in the evaluation of suicide prevention measures and the qual...

Background Accurate and timely infectious disease surveillance is pivotal for effective public health responses. An important component of this is the disease surveillance tools used. Understanding views and experiences of users is crucial for informing policy decisions and ensuring the seamless functioning of surveillance systems. Objective In th...

Strengthening management and leadership competencies among district and local health managers has emerged as a common approach for health systems strengthening and to achieve Universal Health Coverage (UHC). While the literature is rich with localised examples of initiatives that aim to strengthen the capacity of district or local health managers,...

Background The implementation of digital disease surveillance systems at national levels in Africa have been challenged by many factors. These include user applicability, utility of IT features but also stable financial support. Funding closely intertwines with implementations in terms of geographical reach, disease focus, and sustainability. Howev...

Background: The revised classification of Somatic Symptom Disorder (SSD) according to DSM-5 no longer considers whether physical symptoms are medically unexplained. Instead, new psychobehavioral positive criteria are diagnostically relevant – irrespective of the etiology of the complaints. Our study, conducted within the "SomPsyNet" project, inves...

Introduction Suicide is a significant public health problem, impacting individuals, families and communities worldwide. Effective suicide prevention requires a comprehensive approach with diverse integrated interventions and collaboration across sectors, stakeholders and professions. This study aims to identify challenges, gaps and success factors...

Background Health administrations require evidence, meaning robust information, data, and research, on health services and systems. Little is known about the resources and processes available within administrations to support evidence-informed policymaking. This study assessed Swiss health administrations’ capacity for evidence use and investigated...

Effective and sustainable strategies are needed to address the burden of preventable deaths among children under-five in resource-constrained settings. The Tools for Integrated Management of Childhood Illness (TIMCI) project aims to support healthcare providers to identify and manage severe illness, whilst promoting resource stewardship, by introdu...

Assessment of Somatic Symptom Disorder in General Hospital Care (Abstract: Journal of Psychosomatic Medicine and Psychotherapy)

BACKGROUND Accurate and timely infectious disease surveillance is pivotal for effective public health responses. In this study, we assessed the user perceptions of three disease surveillance tools used in Côte d'Ivoire: MAGPI, DHIS2 and SORMAS; the latter was implemented in 2021 within a pilot scheme. OBJECTIVE Understanding views and experiences...

The paper draws learning from an action implementation research on the tools for integrated management of childhood illnesses (TIMCI). Health Care Provider Perceptions on Technology-Driven Interventions at Primary Health Care Level are discussed with recommendations for best practices and scale up

Background The Ghana-based SAVING consortium aims to identify and address implementation challenges for the delivery of new medical interventions, such as RTS,S, the malaria vaccine introduced in Ghana in 2019. Inoculation is at 6, 7, 9 and 24 months of age. The lifesaving potential of the vaccine can be limited by its effectiveness and implementat...

Introduction Approximately 30% of somatic hospital inpatients experience psychosocial distress, contributing to increased (re-)hospitalisation rates, treatment resistance, morbidity, and direct and indirect costs. However, such distress often remains unrecognised and unaddressed. We established ‘SomPsyNet’, a ‘stepped and collaborative care model’...

Background The Surveillance Outbreak Response Management and Analysis System (SORMAS) has been implemented for various infectious diseases since 2015. 2020, at the beginning of the COVID-19 pandemic, SORMAS was adapted to SARS-CoV2. Methods We assessed the acceptability and usability of SORMAS and accompanied its implementation in two pilot region...

Background In the past 2 decades, many countries have recognized the use of electronic systems for disease surveillance and outbreak response as an important strategy for disease control and prevention. In low- and middle-income countries, the adoption of these electronic systems remains a priority and has attracted the support of global health pla...

With the COVID-19 pandemic, the notion of health system (HS) performance has been discussed, and the notion of resilience has become increasingly important. Lacking a recognised framework that measures the performance of HSs throughout a crisis, i.e., one that explicitly includes time as a key aspect, we examined the literature about conceptual fra...

Background Stepped and Collaborative Care Models (SCCMs) have shown potential for improving mental health care. Most SCCMs have been used in primary care settings. At the core of such models are initial psychosocial distress assessments commonly in form of patient screening. We aimed to assess the feasibility of such assessments in a general hospit...

Background: Human resources are vital for delivering health services, and health systems cannot function effectively without enough skilled, motivated, and well-supported health workers. Even though several studies have addressed job satisfaction among healthcare professionals in different parts of the world, there is limited research examining int...

BACKGROUND In the past 2 decades, many countries have recognized the use of electronic systems for disease surveillance and outbreak response as an important strategy for disease control and prevention. In low- and middle-income countries, the adoption of these electronic systems remains a priority and has attracted the support of global health pla...

Introduction Although well-performing workforce is essential to equitable and efficient health service delivery, few countries have systematically addressed performance improvements. How health workers use their work time and what tasks they accomplish is here an important starting point. Therefore, a time motion study was conducted to assess the w...

Objective The financial burden from noncommunicable diseases (NCDs) is a threat worldwide, alleviated only when good social protection schemes are in place. Albeit the Government in Albania has committed to Universal Healthcare Coverage (UHC), Out-of-Pockets (OOPs) persist. Through this study, we aimed to assess the OOPs related to consultations, d...

Background Since 2017, PERFORM2Scale, a research consortium with partners from seven countries in Africa and Europe, has steered the implementation and scale-up of a district-level health management strengthening intervention in Ghana, Malawi and Uganda. This article presents PERFORM2Scale’s theory of change (ToC) and reflections upon and adaptatio...

Background Resilience has become relevant than ever before with the advent of increasing and intensifying shocks on the health system and its amplified effects due to globalization. Using the example of non-state actors based in Switzerland, the aim of this study is to explore how and to what extent NGOs with an interest in global health have dealt...

Background The coronavirus disease 2019 (COVID-19) pandemic and related countermeasures hinder health care access and affect mental wellbeing of non-COVID-19 patients. There is lack of evidence on distress and mental health of patients hospitalized due to other reasons than COVID-19—a vulnerable population group in two ways: First, given their risk...

The quality of care (QoC) of primary health care (PHC) services in Albania faces challenges on multiple levels including governance, access, infrastructure and health care workers. In addition, there is a lack of trust in the latter. The Health for All Project (HAP) funded by the Swiss Agency for Development and Cooperation therefore aimed at enhan...

Background: Resilience has become relevant than ever before with the advent of increasing and intensifying shocks on the health system and its amplified effects due to globalization. Using the example of non-state actors based in Switzerland, the aim of this study is to explore how and to what extent NGOs with an interest in global health have deal...

Objective The aim of this study is to improve the understanding of the characteristics of health system resilience in Myanmar’s response to Cyclone Nargis and to explore ways to improve resilience at the system level. Design and setting This is an explanatory qualitative study exploring the institutional capacity of resilience in Myanmar’s health...

Health system resilience, known as the ability for health systems to absorb, adapt or transform to maintain essential functions when stressed or shocked, has quickly gained popularity following shocks like COVID-19. The concept is relatively new in health policy and systems research and the existing research remains mostly theoretical. Research to...

Health system resilience, known as the ability for health systems to absorb, adapt or transform to maintain essential functions when stressed or shocked, has quickly gained popularity following shocks like COVID-19. The concept is relatively new in health policy and systems research and the existing research remains mostly theoretical. Research to...

Background Mental–somatic multimorbidity in general hospital settings is associated with long hospital stays, frequent rehospitalization, and a deterioration of disease course, thus, highlighting the need for treating hospital patients more holistically. However, there are several challenges to overcome to address mental health conditions in these...

Background In 2003, Ghana implemented a National Health Insurance Scheme (NHIS) designed to promote universal health coverage and equitable access to health care. The scheme has largely been successful, yet it is confronted with many challenges threatening its sustainability. Out-of-pocket payments (OOP) by insured clients is one of such challenges...

Aim: Assess the use of different health care service providers by adults (aged 18–59) and elderly (aged > =60) who suffer from non-communicable disease (NCD) and explore relationships between sociodemographic variables and care-seeking behaviors. Methods: A cross-sectional survey was conducted in the districts of Diber and Fier in December 2018, us...

Background Addressing the uptake of research findings into policy-making is increasingly important for researchers who ultimately seek to contribute to improved health outcomes. The aims of the Swiss Programme for Research on Global Issues for Development (r4d Programme) initiated by the Swiss National Science Foundation and the Swiss Agency for De...

The shift from inpatient care to the ambulatory sector is a central aspiration of European health systems. Despite demonstrated benefits, health reforms have struggled to realize their potential. In this context, we discuss recent hospital sector reforms in Switzerland and analyze the content, process, and role of evidence in the recent introductio...

Background: A country's health system faces pressure when hit by an unexpected shock, such as what we observe in the midst of the coronavirus disease 2019 (COVID-19) pandemic. The concept of resilience is highly relevant in this context and is a prerequisite for a health system capable of withstanding future shocks. By exploring how the key dimens...

Introduction: The Ghana National Health Insurance Scheme has resulted in increases in coverage, availability and utilization of healthcare services. An 8-year review showed increased in coverage from 33% in 2010 to 41% in 2015. In spite of these increases, the population of the poor enrolled as indigents remains low. Objective: The study assessed t...

Background In 2003, Ghana implemented a national health insurance scheme (NHIS) designed to promote universal health coverage and equitable access to health care. The scheme has largely been successful, yet it is confronted with many challenges threatening its sustainability. Out-of-pocket payments (OOP) by insured clients is one such challenges of...

Background: The introduction of social health insurance in developing countries is an important policy to improve financial access to health care. In 2003, Ghana implemented a national health insurance scheme (NHIS) designed to promote universal health coverage and equitable access to health care. The scheme has largely been successful, yet it is c...

Objectives To identify key factors influencing the utilisation of governmental and private primary healthcare services in Albania. Design A cross-sectional health facility survey using a 4-point Likert scale questionnaire to rank the importance of factors driving services utilisation. Setting Exit interviews with patients who consulted one of 23...

Background Aiming to tackle the rise of non-communicable diseases and an ageing population, Albania is engaged in boosting primary healthcare services and quality of care. The patients’ perspectives on their experience with public and private providers are, however, missing, although their viewpoints are critical while shaping the developing servic...

Introduction: Economic analysis of supply chain management interventions to improve the availability of healthcare commodities at healthcare facilities is important in generating evidence for decision-makers. The current study assesses the cost and cost drivers for setting-up a public-private partnership programme in Tanzania in which all public h...

Background: The current study builds upon a previous situation analysis of the extent to which grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) are being utilized to support operational research and implementation research (OR/IR) activities in recipient countries. The objective of this follow-up study was to ident...

Introduction: District health managers (DHMs) play a pivotal role in the operation of district health systems in low—and middle income countries, including Ghana. Their capacity is determined by their competencies, but also by the organization and system in which they are embedded. The objective of this paper is to explore how district health manag...

Objectives This study sought to answer two questions: (1) what are the characteristics of young Kenyans aged 18–24 who use contraception obtained at pharmacies, and (2) why are pharmacies appealing sources of contraception? Design and setting This was a mixed-methods study in one peri-urban part of Kwale County, Kenya. Methods included cross-secti...

There is a little-known study about how family doctors actually use their working time providing patient care, administration, and other activities. This paper investigates this issue for family doctors who are working in health facilities of a rural area in Tajikistan. To capture information about time allocation, 24 family doctors were observed d...

Background: Within its reform efforts, the Government of Tajikistan is embracing the essential role of primary health care (PHC) in decreasing out of pocket (OOP) expenditures and increasing equity in access to health services. In the light of the increasing burden of disease relating to chronic conditions, we investigated OOP expenditures of pati...

Background: Pharmaceutical supply chain management in low- and middle-income countries has received substantial attention to address the shortage of medicines at peripheral facilities. The focus has been on health system interventions, including the establishment of public-private partnerships (PPPs). In 2014, the United Republic of Tanzania began...

Background: Access to safe, effective, quality and affordable essential medicines for all is a central component of Universal Health Coverage (UHC). However, the availability of quality medicines in peripheral healthcare facilities is often limited. Several countries have developed integrated complementary pharmaceutical supply systems to address...

Objectives This Kenya-based study ascertained whether pharmacies were an untapped source of ‘youth-friendly’ health services by determining (1) whether young people (aged 18–24) could successfully obtain condoms and emergency contraception (ECP); (2) whether contraceptives were dispensed according to national guidelines; and (3) how young people fe...

Background The current study builds upon a previous situation analysis of the extent to which grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) are being utilized to support operational research and implementation research (OR/IR) activities in recipient countries. The objective of this follow-up study was to identif...

Background: The current study builds upon a previous situation analysis of the extent to which grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) are being utilized to support operational research and implementation research (OR/IR) activities in recipient countries. The objective of this follow-up study was to identi...

Background: The Philippines decentralized government health services through devolution to local governments in 1992. Over the years, opinions varied on the impact of devolved governance to decision-making for local health services. The objective of this study was to analyze decision-makers' perspectives on who should be making decisions for local...

Background: Competing priorities in health systems necessitate difficult choices on which health actions and investments to fund: decisions that are complex, value-based, and highly political. In light of the centrality of universal health coverage (UHC) in driving current health policy, we sought to examine the value interests that influence agen...

Background: Aiming to tackle the rise of non-communicable diseases and an ageing population, Albania is engaged in boosting primary healthcare services and quality of care. The patients’ perspectives on their experience with public and private providers are, however, missing, although their viewpoints are critical while shaping the developing servi...

Background: Aiming to tackle the rise of non-communicable diseases and an ageing population, Albania is engaged in boosting primary healthcare services and quality of care. The patients’ perspectives on their experience with public and private providers are, however, missing, although their viewpoints are critical while shaping the developing servi...

Background: A well-functioning education system for family nurses is a priority of the primary health care reform in Tajikistan. In 2015/2016, a baseline study was carried out to measure the educational environment at two nursing colleges, in Kulob and Dushanbe. Building on the study's recommendations, the educational reform has addressed several...

Introduction District health managers play a pivotal role in the delivery of basic health services in many countries, including Ghana, as they are responsible for converting inputs and resources such as, staff, supplies and equipment into effective services that are responsive to population needs. Weak management capacity among local health manager...

Low- and middle-income countries have been undertaking health finance reforms to address shortages of medicines. However, data are lacking on how medicine availability and stock-outs influence access to health services in Tanzania. The current study assesses the effects of medicine availability and stock-outs on healthcare utilization in Dodoma reg...

Introduction Young people worldwide are often reticent to access family planning services from public health facilities: instead, they choose to get contraception from private, retail pharmacies. In Kenya, certain contraceptives are available in pharmacies: these include injectables, which can be dispensed but not administered, according national g...

The double burden of malnutrition, an emerging concern in developing countries, can exist at various levels: individual, household, and population. Here, we explore the nutritional status of Tajik women (15-49 years) and children (5-59 months) focusing on overweight/obesity along with undernutrition (underweight, stunting, and micronutrient deficie...

Background For many countries, overcoming problems related to human resources is critical for progress towards Universal Health Coverage. Planning the workforce means to make decisions on required number, qualification and distribution of health workers. In Tajikistan, despite significant reforms, the health workforce is unequally distributed with...

Introduction: The lack of appropriate policies and procedures to ensure transparent transfer practices is an important source of dissatisfaction among health workers in low- and middle-income countries. In order to alter and improve current practices, a more in-depth and context-specific understanding is needed. This study aims to (1) identify rat...

Background The Tajik medical education system is undergoing a complex reform to enhance the transition of the healthcare system from its soviet legacy of emphasizing secondary level care/specialisation to become more family medicine and primary health care oriented. The current study presents the first empirical evaluation of the educational enviro...

Background Several studies on decentralisation have used the ‘decision space’ approach to assess the breadth of space made available to decision-makers at lower levels of the health system. However, in order to better understand how decentralisation becomes effective for the health sector, analysis should go beyond assessing decision space and incl...

Background Rotating savings and credit associations (ROSCAs) are highly active in many sub-Saharan African countries, serving as an important gateway for coping with financial risk. In light of the Kenya’s National Hospital Insurance Fund’s (NHIF’s) strategy of targeting ROSCAs for membership enrolment, this study sought to estimate how ROSCA membe...

Background Decentralization is promoted as a strategy to improve health system performance by bringing decision-making closer to service delivery. Some studies have investigated if decentralization actually improves the health system. However, few have explored the conditions that enable it to be effective. To determine these conditions, we have an...

Analyzing the effectiveness of decentralization in improving the health sector with a focus on the Philippines. Key Informant Interview (KII) Guide. (PDF)

Aims of the study: To assess the health-seeking behaviour, the patient delay (onset of symptoms to first consultation) and the health system delay (first consultation to start of tuberculosis treatment) among patients with pulmonary tuberculosis (TB) diagnosed in Switzerland, and to assess the predictors of the various types of delay. Methods: A...

Objective: To analyze the role of stakeholders to three alternative strategies to improve processes and practices regarding the regulation, assessment, and management of orthopaedic medical devices in Mexico. Materials and methods: The study was based on document analysis and 17 structured interviews with multiple key actors within the Mexican h...