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.
more
The Capacity Project worked to strengthen HRIS in several low-resource countries to assist decision-makers and human resources managers in identifying and responding to critical gaps in HRH. The findings and recommendations in this report cover the Capacity Project’s implementation of HRIS in Swaz...iland, Rwanda and Uganda.
more
The uneven distribution of HIV risks and burdens across populations is a well-substantiated fact, though seldom publicly acknowledged. Gay men and other men who have sex with men, people who inject drugs, sex workers, and transgender women are 24, 24, 13.5, and 49 times more likely to acquire HIV, ...respectively, than other reproductive aged adults (15 years old and older). Globally, new infections among these key populations account for 45% of all new HIV infections. This figure is likely to be an underestimate, given the intense stigma associated with disclosing and reporting acquisition risks for HIV among gay men, people who use drugs, sex workers, and transgender people. In addition, HIV epidemics in the majority of low- and middle-income countries (90 of 120) have concentrated epidemics among key populations. In countries with more broadly generalized epidemics, risks are still not evenly distributed and key populations still shoulder disease burden that is markedly disproportionate.
more
2nd Generation HIV Surveillance in Pakistan, Round 5
The Overall objective of this mapping study was to update population size estimates of selected key populations (PWID, FSWs, MSM & TGs) to create evidence for developing action plans for HIV prevention interventions in Pakistan. A total numbe...r of 23 cities/towns were selected for Mapping. This included 13 cities in Punjab province, 6 in Sindh Province and 2 cities each in KPK and Baluchistan provinces.
large file: 70,5 MB The preview/download includes only the pages 1 to 23.
more
UNICEF analysis indicates that:
- Investments that increase access to high-impact health and nutrition interventions by poor groups have saved almost twice as many lives as equivalent investments in non-poor groups.
- Access to high-impact health and nutrition interventions has improved ra...pidly among poor groups in recent years, leading to substantial improvements in equity.
- During the period studied, absolute reductions in under-five mortality rates associated with improvements in intervention coverage were three times faster among poor groups than non-poor groups.
- Because birth rates were higher among the poor, the reduction in the under-five mortality rate translated into 4.2 times more lives saved for every 1 million people. Indeed, of the 1.1 million lives saved across the 51 countries during the final year studied for each country, nearly 85 per cent were among the poor.
- Intensified focus on equity-enhancing policies and investments can help countries achieve the Sustainable Development Goal newborn and child mortality targets (SDG3.2).
more
To complement the Global Strategy progress reporting, this report provides a detailed look at country leadership and action toward the Every Newborn National Milestones by 2020. Countries have taken the initiative to show the way forward and have demonstrated significant progress. As part of monitor...ing this progress, countries have adopted the Every Newborn Tracking Tool. This report presents a compilation of the data collated by the Every Newborn Tracking Tool in 2016, when 51 countries adopted the tool; it also spotlights examples of specific country activity for each National Milestone. Finally, Global Milestones for 2020 were part of the Every Newborn Action Plan to guide global and regional work in support of country efforts and this report highlights relevant progress towards those Global Milestones.
more
The Ministry of Health conducted STEPS surveys on adult risk factors surveillance in Myanmar in 2003, 2009 and 2014. Amongst these three surveys, the 2014 one is the most comprehensive, providing an analysis of all States and Regions within Myanmar through not only questionnaires and physical measur...ements – STEPs 1 and 2 of the survey – but also with data obtained through biochemical measurements (STEP 3).
The STEPS survey was initiated by the Ministry of Health in December 2014 with the technical support of WHO Headquarters, regional and country offices.
more
The Republic of the Union of Myanmar is at a historic moment, with a new civilian government assuming power in 2016. The country graduated to lower-middle-income status in 2015, and has made significant progress in reducing poverty, improving food security and addressing malnutrition.
The remai...ning challenges to food and nutrition security and achievement of Sustainable Development Goal 2 targets include continued population displacements resulting from conflict, vulnerability to extreme weather events, poverty, limited social protection coverage, high malnutrition and persistent gender inequalities.
more
Policy note: Cambodia Health Systems in Transition.
The health system includes a mix of public and private providers. The use of private providers is much greater among the wealthy, while the use of informal-sector health providers is greater among the poor. Due to these circumstances there is ...considerable scope to establish appropriate public-private cooperation and to reinforce the regulatory mandate of the Ministry of Health (MOH).
more
Policy Note: Thailand Health Systems in Transition
By 2002, Universal Health Coverage was achieved through three public insurance schemes: the Civil Servant Medical Benefit Scheme (CSMBS) for civil servants and their dependents, Social Health Insurance (SHI) for formal sector employees, and the U...niversal Coverage Scheme (UCS) for the remainder of the population.
The establishment of these three schemes has changed the way health care is financed. A supply-led system, under which all Ministry of Public Health (MOPH) health facilities received an annual budget allocation from the MOPH, has now been completely replaced by a system in which the three public purchasers - separated through a purchaser-provider split - manage a demand-led system of financing.
more
Policy Note #1: Myanmar Health Systems in Transition Policy Notes Series
The Government of the Republic of the Union of Myanmar is committed to achieving universal health coverage (UHC) by 2030. In practice, this means that over the next 15 years the aim is to progressively ensure that all peop...le in all parts of the country have access to the health-care services they need – both preventive and curative – without suffering financial hardship when paying for them.
This policy note is the first in a set of four. It provides an overview of the challenges to be overcome in making progress toward UHC and sets out recommendations for how they can be tackled. The other notes look in more detail at three specific issues: how UHC can improve equity, and how strengthening the township health system and expanding financial risk protection contribute to UHC.
more
Policy Note #2: Myanmar Health Systems in Transition Policy Notes Series
Myanmar is a country in which people’s access to health services is determined more by where they live than their need for care – a situation that is fundamentally inequitable. The challenge is to reduce levels of ineq...uity between different groups in the population and different geographical areas, and most particularly to ensure that health services reach poor and disadvantaged groups, including minorities and those living in conflict-affected areas.
more
Policy Note #3: Myanmar Health Systems in Transition Policy Notes Series
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban areas. For the vast majority of Myanmar’s people, particularly the 70% who reside in rural areas, the ...township health system (THS) is the only government-funded source of preventive, promotive and curative services.
To achieve the national policy objective of progressing towards universal health coverage (UHC) through a primary health-care approach by 2030, the THS is critical to success. It is responsible for the bulk of health care delivery – particularly in rural areas – and is at the heart of national health development in Myanmar. However, if the THS is to be the backbone of health care provision, it currently suffers from a severe case of osteoporosis.
more
Policy Note #4: Myanmar Health Systems in Transition Policy Notes Series
Protecting people from financial hardship when they fall ill is one of the two key elements of universal health coverage (UHC). In practice, this means that the majority of health care costs have to be met from government ...revenues so that services are provided free or with a small affordable co-payment. The alternative is to rely on pre-payment through some form of insurance, where risks are pooled across all contributors.
The challenge in Myanmar is that at present neither approach is functioning. Government spending is too low to meet people’s health needs and the proportion of the population covered by insurance is negligible. As a result, families face a stark choice in the event of serious illness: either defer treatment and face the consequences, or incur what can amount to catastrophic expenses and a downward spiral of disinvestment and poverty.
more
This Case Study explores flood forecasting systems from the perspective of its position within the flood warning process. A method for classifying the different approaches taken in flood forecasting is introduced before the elements of a present-day flood forecasting system are discussed in detail. ...Finally, the state of the art in developing flood forecasting systems is addressed including how to deal with specific challenges posed.
The target group of this case study are decision makers in disaster risk management and/or water management. The case study should help to understand some hydrologic basics of the flood forecast and assist in the administration and implementation of an appropriate flood warning system in a specific environment, to find the best solution for a region.
Best solutions depend mainly on quality and availability of data, the areas and/or points of interest, catchment properties, cross border catchments, and financial capabilities with special consideration of flood forecast.
more
The CBDRR Manual is a practical ‘how-to’ guide on community-based disaster risk reduction for government and non-government agencies in Lao PDR. It is a commonly agreed document to be referred to by agencies working on CBDRR in Lao PDR. It provides guidance and support for systematic implementat...ion of CBDRR programs by explaining each of the steps as well as tools used.
The manual will also support the Government of Lao PDR (GoL) to monitor CBDRR activities, oversee progress of activities implemented by different actors and locations, provide necessary support on CBDRR technical knowledge as well as provide a reference point for replication of initiatives for local government and implementing agencies.
more