From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the lit...erature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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There is no guarantee that a successful pilot program introducing a reproductive health innovation can also be expanded successfully to the national or regional level, because the scaling-up process is complex and multilayered. This article describes how a successful pilot program to integrate the S...tandard Days Method (SDM) of family planning into existing Ministry of Health services was scaled up nationally in Rwanda.
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Consultancy to conduct desk review on impact of national policies and programs on disability rights and develop an action plan to make existing policies and programs and legislation disability friendly
We created this booklet to share our patients’ stories with a larger community. Too many historical injustices go unacknowledged in Iraq, and human rights abuses continue to this day. We feel it is essential to uncover these injustices and help our patients speak out, in the hope that one day all... people will enjoy their fundamental human rights in Iraq.
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The rise of the discourse of 'trauma' as a major articulator of suffering within Western culture is a facet of the medicalization of life that has gathered pace in the last century. In recent years, Western mental health professionals have been increasingly involved in services addressing the plight... of war-affected populations - largely non-Western - in war zones or as refugees. Querying the extent to which their experiences can be reduced to a matter of mental health, this article addresses child refugees from war via three questions that go to the heart of the debate about how they are to be understood, the implications for their future maturation as individuals and citizens, and the role of psychological therapies aimed at catharsis of 'traumatic' memory.
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The aim of this study was to determine the impact of the domestic care environment on the prevalence of potentially traumatic events (PTEs) and posttraumatic stress disorder (PTSD) among orphaned and separated children in Uasin Gishu County, western Kenya.
PLos One March 2014 | Volume 9 | Issue 3 |... e89937
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In this course you will examine the interconnections between poverty, development and violent conflict. This is one of seven Medical Peace Work courses.
The question of amnesties has come to the forefront once again as the Central African Republic (CAR) started a new round of African Union-mediated peace negotiations on 24 January 2019. While rebel groups demanded a general amnesty as a non-negotiable condition, the government maintained strong oppo...sition to any new amnesty. The Khartoum peace agreement signed on 6 February 2019 did not uphold rebel groups’ demand for a general amnesty, but it leaves many grey areas concerning the question of amnesty and justice.
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery ...of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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Singing to the Lions is a free training package (facilitator’s guide, supplement and video) by CRS, that is designed to help children and youth lessen the impact of violence and abuse in their lives. The main component is a three-day workshop where participants learn skills that can help them tran...sform their lives and no longer feel dominated by fear. Although the workshop is aimed at young people and includes games, art and songs, it can also be used to help adults take action on aspects of their lives that cause fear and, in so doing, become better parents and caregivers.
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Singing to the Lions es un paquete de capacitación gratuito (guía del facilitador, suplemento y video) de CRS, que está diseñado para ayudar a los niños y jóvenes a disminuir el impacto de la violencia y el abuso en sus vidas. El componente principal es un taller de tres días en el que los pa...rticipantes aprenden habilidades que pueden ayudarlos a transformar sus vidas y ya no sentirse dominados por el miedo. Aunque el taller está dirigido a jóvenes e incluye juegos, arte y canciones, también se puede utilizar para ayudar a los adultos a tomar medidas en aspectos de sus vidas que causan miedo y, al hacerlo, convertirse en mejores padres y cuidadores.
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The IDF Diabetes Atlas report highlights the disproportionate prevalence of type 2 diabetes (T2D) among Indigenous Peoples globally. It emphasizes the social and health disparities resulting from colonization, loss of traditional practices, and systemic inequities. The report includes prevalence dat...a across various Indigenous populations, identifying significant variability and often higher rates among Indigenous women compared to men. The report calls for culturally responsive and community-driven interventions to address diabetes prevention and management while advocating for better data collection and representation to support Indigenous communities worldwide.
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The module is currently available in English, French, Nepali, Portuguese, Russian, and Spanish
Developing protocols for use with refugees
and internally displaced persons
The People’s Charter for Health is a statement of the shared vision, goals, principles and calls for action that unite all the members of the PHM coalition. It is most widely endorsed consensus document on health since the Alma Ata Declaration
Available in different languages
An approach to emergency situations. Relief workers face rapidly changing and complex environments, new disease patterns, enormous humanitarian needs and relatively limited resources. The authors of this book use their experience in the area to produce an operational manual of the issues involved in... refugee health programs. This book is aimed at professionals involved in public health assistance to refugees and displaced persons. It deals with a variety of specific refugee health issues at the decisional level, and discusses the priorities of intervention during the different phases of a refugee crisis, from emergency to repatriation.
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A set of basic guidelines on how to be accountable to local people and measure program impact in emergency situations. The "good enough" approach emphasizes simple and practical solutions and encourages the user to choose tools that are safe, quick, and easy to implement