Mari Shojo

Understanding the roles of faith-based health-care providers in Africa: review of the evidence with a focus on magnitude, reach, cost, and satisfaction

At a time when many countries might not achieve the health targets of the Millennium Development Goals and the post-2015 agenda for sustainable development is being negotiated, the contribution of faith-based health-care providers is potentially crucial. For better partnership to be achieved and for health systems to be strengthened by the alignment of faith-based health-providers with national systems and priorities, improved information is needed at all levels. Comparisons of basic factors (such as magnitude, reach to poor people, cost to patients, modes of financing, and satisfaction of patients with the services received) within faith-based health-providers and national systems show some differences. As the first report in the Series on faith-based health care, we review a broad body of published work and introduce some empirical evidence on the role of faith-based health-care providers, with a focus on Christian faith-based health providers in sub-Saharan Africa (on which the most detailed documentation has been gathered). The restricted and diverse evidence reported supports the idea that faith-based health providers continue to play a part in health provision, especially in fragile health systems, and the subsequent reports in this Series review controversies in faith-based health care and recommendations for how public and faith sectors might collaborate more effectively.

FAITH-INSPIRED HEALTH CARE PROVISION IN GHANA: MARKET SHARE, REACH TO THE POOR, AND PERFORMANCE

This paper relies on administrative, household surveys and qualitative data to answer three questions about the services provided by faith-inspired health care providers in Ghana, asking: (1) what is the market share of faith-inspired providers as compared to other types of providers; (2) are there differences in market shares among the poor between faith-inspired providers and other types of providers; and (3) how satisfied are patients with the services received and why are patients choosing faith-inspired providers for care? While estimates based on facilities data, especially for hospitals, suggest that the market share of faith-inspired providers is at 30 percent to 40 percent, estimates from household surveys are at less than ten percent. The market share among the poor of faith-inspired providers appears to be similar to that of public providers, but higher than that of private non-religious providers. The qualitative data suggests that the reasons that lead patients to choose faith-inspired providers are not related directly to religion per se, but rather (perhaps indirectly) to the quality of the services provided, including (but not only) through the values of dignity and respect for patients that these facilities exhibit.

Teaching English as a second language in Sri Lankan primary schools: opportunity and pedagogy

ABSTRACT Policy guidelines in Sri Lanka prescribe how and for how long English should be taught as a second language in primary education but practices on the ground may deviate. Opportunities for teaching and learning and pedagogy are key aspects of the process of learning. Using a large-scale survey this paper addresses (i) how much time is allocated to the teaching of English and how much time is lost, (ii) how English teachers use their time in primary education classrooms and (iii) the factors associated with student-centred learning and on academic learning in general. Around a quarter of the class time is lost through timetabling, teacher absenteeism, lesson start and finish times and teacher off task activity. Teachers who spend more time teaching in class are more likely to be in rural or estate schools and in schools with more facilities, and to have attended the Primary English Language Programme in the past. Teachers who spend more time on student-centred activities are more likely to be teaching Grade 3 than Grade 5, using remedial methods and holding an official ‘appointment’ as an English teacher. Policy implications for Sri Lanka are considered and points of comparison with policies and practices elsewhere raised.

Sri Lanka Education Sector Assessment

A country’s education system plays a pivotal role in promoting economic growth and shared prosperity.Sri Lanka has enjoyed high school-attainment and enrollment rates for several decades. However, it still faces major challenges in the education sector, and these challenges undermine the country’s inclusive growth goal and its ambition to become a competitive upper-middle-income country.The authors of Sri Lanka Education Sector Assessment: Achievements, Challenges, and Policy Options offer a thorough review of Sri Lanka’s education sector—from early childhood education through higher education.With this book, they attempt to answer three questions: • How is Sri Lanka’s education system performing, especially with respect to participation rates, learning outcomes, and labor market outcomes? • How can the country address the challenges at each stage of the education process, taking into account both country and international experience and also best practices? • Which policy actions should Sri Lanka make a priority for the short and medium term? The authors identify the most critical constraints on performance and present strategic priorities and policy options to address them. To attain inclusive growth and become globally competitive, Sri Lanka needs to embark on integrated reforms across all levels of education. These reforms must address both short-term skill shortages and long-term productivity. As Sri Lanka moves up the development ladder, the priorities of primary, secondary, and post secondary education must be aligned to meet the increasingly complex education and skill requirements.