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Interim Framework for the South-East Asia Region 28 October 2020
The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 20
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30, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
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Independent Monitoring Board of the Global Polio Eradication Initiative (Twelfth Report: October 2015)
Although Shiga toxin-producing Escherichia coli (STEC) have been isolated from a variety of food production animals, they are most commonly associated with ruminants from which we derive meat and milk. Because of the widespread and diverse nature of ruminant-derived food production, coupled with the
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near ubiquity of STEC worldwide, there is no single definitive solution for controlling STEC that will work alone or in all situations. Instead, the introduction of multiple interventions applied in sequence, as a “multiple-hurdle scheme” at several points throughout the food chain (including processing, transport and handling) will be most effective.
This report summarizes the review and evaluation of interventions applied for the control of STEC in cattle, raw beef and raw milk and raw milk cheese manufactured from cows’ milk, and also evaluates available evidence for other small ruminants, swine and other animals. The information is presented from primary production, to the end of processing, providing the reader with information on the currently available interventions based on the latest scientific evidence.
This work was undertaken to support the development of guidelines for the control of STEC in beef, raw milk and cheese produced from raw milk by the Codex Committee on Food Hygiene (CCFH).
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Capability and Performance
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 amo
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unt 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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USAID/Afghanistan’s $443 million investment in the Afghan Sustainable Water Supply and Sanitation (SWSS) activity is one of the Agency’s largest single investments in sustainable rural water supply delivery. The project installed about 2,123 wells with hand pumps across Afghanistan from 2009–2
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012. This report presents findings from a retrospective evaluation of a random selection of wells with hand pumps installed under the SWSS project.
This evaluation’s key purpose is to identify factors that support and hinder sustainable water service delivery in different contexts. more
This evaluation’s key purpose is to identify factors that support and hinder sustainable water service delivery in different contexts. more
A list of terms found within the Measures Review Database (MRD). This fact sheet defines various terms from the MRD to help users better understand the measures reviews.
he pandemic has produced an unprecedented economic and social crisis, and it could generate a food, humanitarian, and political crisis if urgent measures are not taken. The policy options for addressing the pandemic entail consolidating national pla
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ns and achieving intersectoral consensus. The response should be structured in three nonlinear and interrelated phases—control, reactivation, and rebuilding—involving the participation of technical actors representing not only the field of health but also other social and economic areas. Measures implemented to control the pandemic as well as measures for the reactivation and rebuilding phases will require increased public investment in health until the recommended parameters are achieved.
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The seventh WHO Report on the global tobacco epidemic analyses national efforts to implement the most effective measures from the WHO Framework Convention on Tobacco Control (WHO FCTC) that are proven to reduce demand for tobacco.
The report show
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ed that while only 23 countries have implemented cessation support policies at the highest level, 116 more provide fully or partially cost-covered services in some or most health facilities, and another 32 offer services but do not cost-cover them, demonstrating a high level of public demand for support to quit.
Tobacco use has also declined proportionately in most countries, but population growth means the total number of people using tobacco has remained stubbornly high. Currently, there are an estimated 1.1 billion smokers, around 80% of whom live in low- and middle-income countries (LMICs).
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Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar
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y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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Health Systems for Outcomes Publication | This report summarizes the findings of a qualitative study on health workers’ performance and career in Rwanda to identify bottlenecks, strengths and shortcomings for human resources in the health sector,
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as perceived by both health workers and users of health services.
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State of Health in the EU Cycle.
With the coronavirus (COVID-19) once again spreading rapidly, and the re-introduction of containment measures to flatten the curve of the epidemic, it is crucial for policymakers to plan effective strategies to re-o
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pen their economies to avoid further re-confinements. This should include much more effective testing, tracing and isolation policies that people can easily follow, as well as improved social distancing measures
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DHS Methodological Report No. 20
This study used Service Provision Assessment (SPA) and Demographic and Health Survey (DHS) data from Haiti, Malawi, and Tanzania to compare traditionally used additive methods with a data reduction method—principal component analysis (PCA).
We scored ... the quality of health facilities with three approaches (simple additive, weighted additive, and PCA) for two constructs: quality of services, with only facilities-level data, and quality of care, which incorporates observation and client data. We ranked facilities as high, medium, or low quality based on their scores. Our results indicated that the rankings change with the scoring methodology. There was more consistency in the rankings of facilities by the simple additive and PCA methods than the weighted additive and PCA-based rankings. This may be due to the low factor loadings and little variance explained by the first component in the PCA. We aggregated facility scores to their respective DHS clusters (Haiti, Malawi) or regions (Tanzania) and geographically linked them to women interviewed in DHS surveys to test associations between the use of family planning services and the quality environment, as measured with each index. more
This study used Service Provision Assessment (SPA) and Demographic and Health Survey (DHS) data from Haiti, Malawi, and Tanzania to compare traditionally used additive methods with a data reduction method—principal component analysis (PCA).
We scored ... the quality of health facilities with three approaches (simple additive, weighted additive, and PCA) for two constructs: quality of services, with only facilities-level data, and quality of care, which incorporates observation and client data. We ranked facilities as high, medium, or low quality based on their scores. Our results indicated that the rankings change with the scoring methodology. There was more consistency in the rankings of facilities by the simple additive and PCA methods than the weighted additive and PCA-based rankings. This may be due to the low factor loadings and little variance explained by the first component in the PCA. We aggregated facility scores to their respective DHS clusters (Haiti, Malawi) or regions (Tanzania) and geographically linked them to women interviewed in DHS surveys to test associations between the use of family planning services and the quality environment, as measured with each index. more
To understand the patterns of Rwanda’s achievements in health development, it is important to explore how Rwanda addresses the Social Determinants of Health (SDH) particularly those related to routine conditions in which people are born, live and work. It is in this particular context that a case
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study on Rwanda’s Performance in Addressing Social Determinants of Health was conducted by the Rwanda Ministry of Health, with technical and financial support from the World Health Organization (WHO). The overall goal of the exercise was to document Rwanda's recent initiatives that contribute to the advancements of the Rio Political Declaration on Social Determinants of Health.
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These include taking proactive measures to ensure that people, particularly people in vulnerable groups, can access HIV treatment and prevention services, designating and supporting essential workers, including community-led organizations, and imple
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menting measures to prevent and address gender-based violence.
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This document aims to provide guidance to healthcare facilities and healthcare providers in the European Union/European Economic Area (EU/EEA) and the United Kingdom (UK) on preparedness and infection prevention and control (IPC) measures for the ma
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nagement of possible and confirmed cases of COVID-19 in healthcare settings, including long-term care facilities (LTCFs). In addition, this document addresses the management of clinical diagnostic specimens at laboratories in the EU/EEA. This is the sixth update of the ECDC guidance on ‘Infection prevention and control and preparedness for COVID-19 in healthcare settings’, and replaces the document dated 6 October 2020.
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PERC produces regional and member state situation analyses, updated regularly.
This document aims to encourage countries to develop and implement policies to maintain and strengthen IPC programmes and measures in health care facilities in the context of the current ongoing transmission of the SARS-CoV-2, with recognition that
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epidemiological trends may vary and the risk of transmission of other pathogens.
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This document briefly describes the macroeconomic performance before the spread of the coronavirus (COVID-19), which is mainly characterized by severe economic depression, economic and financial sanctions by the Trump administration, and tight fisca
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l space that constrains to undertake additional measures. It estimates three economic scenarios based on different oil price assumptions for 2020. The negative effects of the quarantine on the economy are estimated using the two biggest shocks faced by Venezuela in its recent history. It emphasizes the relevance of foreign currency and external financing to mitigate the pandemic’s impact. Finally, this paper discusses the economic measures taken by the government.
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