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Policy Research Working Paper 6100 | Impact Evaluation Series No. 60 | This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find that the incentives had a large and significant effec
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t on the weight-for-age of children 0–11 months and on the height-for-age of children 24–49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill .
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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, as perceived by both health workers and users of he
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alth services.
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This study examines the ability of political, legal, health, and communities to respond to gender-based violence in Kigali, Rwanda.
Through public-private partnerships, the government of Rwanda can make more efficient use of public resources by targeting and meeting the needs of specific populations and thus help ensure family planning services and products will be available to all Rwandans in the long term. This report aims to
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inform stakeholders working to strengthen family planning through multisectoral partnerships about Rwanda’s family market.
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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
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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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The objective of the evaluation is to understand whether the CHW program has achieved its intended objectives, thus contributing to the overarching objectives defined in the HSSP III of improving the health status of the population by “Ensuring universal accessibility of quality health services fo
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r all Rwandans”.
This evaluation has focused on CHWs, who are selected, trained and deployed by the MoH to deliver a defined set of tasks at community level. CHWs are the central element of the Community Health Policy and of the community health strategy plan (CHSP) of the MoH.
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“Our children have the right to an education too”: Strategies Employed by Orange Farm Caregivers of Children with Disabilities in Pursuit of the Right to a Basic Education
Elphick, J., De SasKropiwnicki, Z. &Elphick, R.
Disability, CBR & Inclusive Development Journal (DCIDJ)
(2015)
CC
This paper aims to understand the agency that caregivers who participated in a CBR empowerment component programme exercised, in order to promote the rights of their children with disabilities to a basic education.
This publication offers practical advice on implementing HIV and STI programmes for transgender people, with a focus on transgender women, aligned with the 2011 Recommendations and the 2014 Key Populations Consolidated Guidelines. It contains examples of good practice from around the world that may
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support efforts in planning programmes and services, and describes issues that should be considered and how to overcome challenges.
This tool describes how services can be designed and implemented to be acceptable and accessible to transgender women. To accomplish this, respectful and ongoing engagement with them is essential.
This tool gives particular attention to programmes run by transgender people themselves, in contexts where this is possible. more
This tool describes how services can be designed and implemented to be acceptable and accessible to transgender women. To accomplish this, respectful and ongoing engagement with them is essential.
This tool gives particular attention to programmes run by transgender people themselves, in contexts where this is possible. more
CBM’s approach is based on the principles of the UN Convention on the Rights of Persons with Disabilities (CRPD) and on CBM’s responsibility to promote accessibility and the principles of universal design in all spheres of its work, including CBM’s digital content and communications. With this
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toolkit, we want to provide a guide and practice resource to people working with and for CBM so that together we produce accessible digital content and communications, and place accessibility at the centre of our Information and Communication Technologies (ICT) procurement processes. The toolkit contains a selection of tools for producing accessible content in electronic documents, videos, figures and tools to ensure web accessibility. It also provides tools and information for accessible ICT procurement including tips and resources on how to communicate CBM’s accessibility requirements for products and services being purchased; and how to evaluate what providers promise and deliver.
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This guideline was prepared in close cooperation with CBM travellers with a disability and others who travel together with a person with a disability. Their experiences/testimonies have been collated using a series of guiding questions. This guideline targets travellers with a disability and persona
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l assistants (PA) of travellers with a disability. In addition, this document is useful for anyone who is travelling together with a person with a disability. The aim of this guideline is to raise awareness and help to better prepare for trips. The guideline also gives first-hand advice and best-practice recommendations from persons with a disability for persons with a disability.
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The objective of this Security Guideline for People with Albinism is to provide concrete and specific advice to people with albinism as well as those working with them, to remain safe within the context of where they live. It also provides easy to implement steps in handling an incident and swiftly
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mobilize useful resources to try and return a victim back to safety.
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Guidelines for managing advanced HIV disease and rapid initiation of antiretroviral therapy
World Health Organization (WHO)
(2017)
C_WHO
The objectives of these guidelines are to provide recommendations outlining a public health approach to managing people presenting with advanced HIV disease, and to provide guidance on the timing of initiation of antiretroviral therapy (ART) for all people living with HIV.
WHO recommends that a ... package of screening, prophylaxis, rapid ART initiation and intensified adherence interventions be offered to everyone living with HIV presenting with advanced disease.
WHO strongly recommends that rapid ART initiation should be offered to people living with HIV following confirmed diagnosis and clinical assessment. Rapid initiation of ART is defined as within seven days of HIV diagnosis. WHO further strongly recommends ART initiation on the same day as HIV diagnosis based on the person’s willingness and readiness to start ART immediately, unless there are clinical reasons to delay treatment. more
WHO recommends that a ... package of screening, prophylaxis, rapid ART initiation and intensified adherence interventions be offered to everyone living with HIV presenting with advanced disease.
WHO strongly recommends that rapid ART initiation should be offered to people living with HIV following confirmed diagnosis and clinical assessment. Rapid initiation of ART is defined as within seven days of HIV diagnosis. WHO further strongly recommends ART initiation on the same day as HIV diagnosis based on the person’s willingness and readiness to start ART immediately, unless there are clinical reasons to delay treatment. more
The purpose of the PAS III is to guide Pakistan’s overall national response for HIV and AIDS through 2020, through focused interventions with set targets, costs, roles and responsibilities. The successful implementation of PAS III involves multiple stakeholders to achieve priority outcomes outline
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d in the Strategy. The Strategy focuses on allocating limited resources to scale up high-impact, high-value interventions such as HTC and treatment to reduce AIDS related deaths and new HIV infections. Priorities in the PAS III have been identified to ensure maximum impact in reducing new infections, especially among key populations, improving treatment uptake and retention, and improving the quality of life of people living with HIV and AIDS in the context of limited financial and human resources.
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Tracking aid for the WHA nutrition targets: Global spending in 2015 and a roadmap to better data
Alimonte, Mary D'; Thacher, Emily; LeMier, Ryan; Clift, Jack
Results for Development (R4D)
(2018)
C1
In 2017, the World Bank and partners created the Global Investment Framework for Nutrition as a roadmap towards achieving the World Health Assembly (WHA) nutrition targets by 2025. The framework estimates that the world needs to mobilize an annual additional investment of $7 billion per year to scal
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e-up nutrition-specific interventions at the level needed to achieve the global targets. However, the world is off-track to meet the global targets. And it is unclear whether additional resources will be mobilized for life-saving and cost-effective nutrition-specific interventions, or whether donor support will be enough to meet the annual resource need established by the framework.
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Delivering quality health services: A global imperative for universal health coverage
Kieny, Marie-Paule; Evans, Timothy Grant; Scarpetta, Stefano; Kelley, Edward T.; Klazinga, Niek; Forde, Ian; Veillard, Jeremy Henri Maurice; Leatherman, Sheila; Syed, Shamsuzzoha; Kim, Sun Mean; Nejad, Sepideh Bagheri; Donaldson, Liam
World Health Organization (WHO), Organisation for Economic Co-operation and Development (OECD), and The World Bank
(2018)
C_WHO
Poor quality health services are holding back progress on improving health in countries at all income levels.
Today, inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training an ... d expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries. more
Today, inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training an ... d expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries. more
This learning report attempts to understand the drivers for, and barriers to, effective implementation as well as review the experiences of Start Fund members in responding to these outbreaks to support evidence-based decision-making within the Start Network at project, crisis, and system level. Spe
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cifically, it analyses the effectiveness, efficiency, and relevance of Start Fund disease outbreak responses by reviewing and analysing funding, decision-making and response activities before ultimately exploring implications and recommendations.
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