Rapport biennal de la directrice régionale
For handwashing to be effective, it needs to be practiced consistently and thoroughly. Even when people have access to soap and water, and know how and why to wash their hands, many still do not properly wash their hands consistently at critical times. The handwashing behavior change challenge is no...t only to encourage people to wash their hands with soap, but to do so correctly and at all critical times.
Nudges are one example of a behavior change tool that can encourage people to wash their hands.
Although the evidence base for nudges is still emerging and nudges for handwashing have been tested primarily in single contexts or on a limited scale, this brief and infographic answer some frequently asked questions about nudges and provides examples of how they have been used in efforts to increase handwashing.
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This policy will serve as a cornerstone from which to address the accessibility of Family Planning services and to encourage its integration with services for HIV/AIDS, maternal health, child health, and other development initiatives. This policy is timely, as Rwanda is embarking on the introduction... of community-based provision of Family Planning through community health workers. In addition, the expansion of adolescent sexual and reproductive health programs is a pillar of this policy that will help attract and retain the next generation of Family Planning users. These efforts are anticipated to trigger a paradigm change in the way Family Planning services are provided and accessed in order to contribute towards a healthy and productive Rwanda for all.
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In recent years, Rwanda has been on the fast track to achieve major health improvements for its entire population. With the support of government agencies and various non-governmental partners, the Ministry of Health (MoH) has endeavored to decentralize Rwanda’s health system and bring health serv...ices closer to the people. Guided by multitude of national and international development frameworks, Rwanda’s healthcare successes include the establishment of a community health insurance scheme (mutuelle de santé), a system of cooperative-financed community health workers in every village, and interventions for researching, preventing, and treating diseases like HIV/AIDS, TB, and malaria.
As the MoH continues to design innovative means to reach and surpass its prescribed health outcome targets, it will hold as core principles the integration of service provision, the increase in healthcare capacity, and the attainment of sustainable funding sources. Rwanda is committed to achieving the Millennium Development Goals by 2015 and has declared Family Planning (FP) a national priority for poverty reduction and socioeconomic development of the country. Modern contraceptive use has more than quadrupled from 2005 to 2010, rising from 10% to 45%, but the government’s Economic Development and Poverty Reduction Strategy calls for an increase the modern contraceptive prevalence to 70% by 2016. While structural changes in health care and supply chains have led to noteworthy improvements in FP and other services, there are still many challenges that must be overcome. As such, a strategic plan is needed to coordinate FP efforts around a well-defined set of objectives and responsibilities.
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Nepal has performed exceptionally in improving reproductive, maternal and child health outcomes over the past two decades. In this article, we discuss these achievements and outline a vision for the future of maternal, newborn and child survival in Nepal after the era of the Millennium Development G...oals. On the pathway towards quality universal health care services for all, we propose strengthening of health information systems, gradual health system reforms, improvement of existing facility based services, development of integrated service delivery models, improved technical and managerial capacity at district and facility levels. Elimination of all preventable causes of maternal, newborn and child deaths in Nepal should be our collective aspirational goal.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 110
This report compiles evidence from published, grey literature and key informants on the UNMHCP
since its introduction in Uganda’s health system, and findings were further validated during a oneda...y
national stakeholder meeting.
Three main factors motivated introduction of the UNMHCP. First, Uganda, along with other lowincome countries, was unable to implement holistically the primary healthcare (PHC) concepts as set out in the Alma Ata Declaration. Second, the macro-economic restructuring carried out in the 1990s, which was an international conditionality for low-income countries to access development financing, influenced the trend towards more stringent prioritisation of health interventions as a means of rationing and targeting use of resources. Third, the government sought to achieve equity with a service package that would be universally available for all people.
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The document contains a set of indicators that can be used for monitoring traditional and complementary medicine (T&CM) systems in a country.
The core indicator set consists of 16 indicators that were considered essential and collectively able to provide information on T&CM inputs, processes and ou...tputs. A longer list of reference indicators is also available for countries that wish to monitor more indicators or that want to consider alternative metrics that would better suit each country’s T&CM situation, priorities and monitoring capacities.
Each core and reference indicator is accompanied by a set of metadata. This provides information on the indicator rationale, definitions, data elements (numerator, denominator and data disaggregation), frequency of measurement, and data sources. It is a guide towards more standardized data measurement as well as data interpretation.
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Effective malaria prevention is threatened by widespread and increasing vector insecticide resistance. Failure to mitigate this threat will likely result in an increased burden of disease, with significant cost implications. This new framework provides support for the development of a national insec...ticide resistance monitoring and management plan as part of a national malaria strategic plan.
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L’ampleur de la résistance aux insecticides chez les vecteurs du paludisme met en péril l’efficacité des programmes de lutte anti-vectorielle. Si cette résistance n’est pas atténuée, le taux de morbidité palustre va s’accroître, entraînant une hausse significative des coûts liés ... la prévention de la maladie. Ce nouveau cadre est un guide pour l’élaboration d’un plan national de suivi et de gestion de la résistance aux insecticides chez les vecteurs du paludisme, lequel doit considéré comme partie intégrante du plan stratégique national de lutte contre le paludisme.
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Recent systematic reviews and meta-analysis of the impact of chemical-based mollusciciding (King et al., 2015, Sokolow et al., 2016) have concluded that regular mollusciciding is likely to contribute significantly towards elimination of schistosomiasis in high-risk areas. The WHO roadmap’s new foc...us on “transmission control, wherever possible” (WHO, 2012a) reinforces the need to promote intermediate-host snail control to prevent schistosomiasis transmission.
This operational manual is intended to facilitate the reintroduction of practices and protocols for use of molluscicides in the field in schistosomiasis control programmes. It is complemented by guidelines on the laboratory and field testing of the efficacy of molluscicides for schistosomiasis control (WHO, 2017 [in preparation]).
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An estimated 59 000 people die from rabies each year. That’s one person every nine minutes of every day, 40% of whom are children living in Asia and Africa. As dog bites cause almost all human cases, we can prevent rabies deaths by increasing awareness, vaccinating dogs to prevent the disease at i...ts source and administering life-saving treatment after people have been bitten. We have the vaccines, medicines, tools and technologies to prevent people from dying from dog-mediated rabies. For a relatively low cost it is possible to break the disease cycle and save lives
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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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This annual report outlines achievements and challenges of delivering these partnerships. NUDOR takes this opportunity to thank all organizations, individuals and decision makers who have supported NUDOR to contribute to the promotion, respect and realization of the rights of persons with disabiliti...es.
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Semi-Annual report of the National Union of Disabilities of Rwanda.
This document addresses the issue of the medical and rehabilitative care of persons with physical disabilities. It is understood that this policy is to be integrated with the policy documents of other advisory working groups. It should also be emphasised that the physical disability work of CBM occu...rs within the context of CBM’s Disability and Development Policy, with a human rights perspective and working toward full inclusion of people with disabilities within
their society.
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