Accessed Online June 2018 | When assessing potential opportunities for family planning, it is important to consider a wide range of areas related to demand for contraception, availability and access to services, quality and equity, and the enabling environment. This opportunity brief brings together... a range of data sources to allow for exploration of these key areas. This brief is meant to provide an overview of key data and population segmentations to spark conversations about prioritization and potential impact. Further analysis, including additional segmentation by residence or region may reveal additional nuances.
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The Newborn Situational Analysis reports of 2009 and 2011, as well as the “Bottleneck analysis on neonatal health” of 2013, culminated in the Nigeria launch of “Call to action on Newborn health” at the first National Newborn Health Conference in 2014. This call to action provided the framewo...rk for the development of the Nigeria Every Newborn Action
Plan (NiENAP). The NiENAP lays out a vision to end preventable stillbirths and newborn deaths by accelerating progress and scaling up evidence- based high-impact and cost effective interventions. The plan is guided by the principles of country-leadership, integration, accountability, equity, human rights, innovation and research. This blue print outlines our commitment as government and stakeholders to repositioning newborn health as we implement approaches that impact on the lives of newborns for improved health outcome.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at distric...t and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole.
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The Monitoring Report, which covers the first two months of the response from 25 August to 31 October, highlights the work of the Government of Bangladesh, in cooperation with humanitarian partners who are working to provide relief services for the refugee population and Bangladeshi host communities.... Of the 1.2 million people in need, around half have been reached with assistance. The Report also explains the challenges and gaps that remain. The risk of disease outbreak is high, and the impact of a cyclone or heavy rain would be massive. There is not enough land to provide adequate living conditions for the more than 830,000 refugees that now crowd Cox’s Bazar.
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Review of International, Regional and National Policies and Legal Frameworks that Promote Migrants and Mobile Populations' Access to Health and Malaria Services in the Greater Mekong Subregion (Cambodia, Lao People's Democratic Republic, Myanmar, Thailand and Viet Nam)
Migrants and mobile popul...ations face many obstacles in accessing equitable essential health care services due to factors such as living and working conditions, education level, gender, irregular migration status, language and cultural barriers, anti-migrant sentiments, and lack of migrant-inclusive health policies among others. Despite significant progress having been made in the context of malaria control in the Greater Mekong Subregion (GMS), human movements can impact malaria transmission patterns and potentially introduce drug-resistant parasites. This legal framework review therefore serves as a guidance document on approaches to address malaria and malaria elimination for migrant and mobile populations (MMPs) in five countries of the GMS.
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Findings on maternal and child health in Nepal, Mozambique and
Rwanda, and neglected tropical diseases in Cambodia and Sierra Leone | This report synthesises findings from five country case studies from the health dimension of this project, which focus on maternal and child health (MCH) (Mozambique...,Nepal, Rwanda) and neglected tropical diseases (NTDs)(Cambodia, Sierra Leone). MCH was selected given its centrality in two of the Millennium Development Goals (MDGs) and its ability to act as a proxy for strengthened health systems. NTDs, while until recently relatively neglected in global policy debates, are now attracting more interest, not least because they are viewed as diseases of the poor whose treatment could positively impact on most of the other MDGs.
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The Kabeho Mwana project (2006–2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda’s 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In p...roject districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems. The iCCM model implemented by Kabeho Mwana resulted in greater improvements in care-seeking than those seen in the rest of the country. Intensive monitoring, collaborative supervision, community mobilization, and CHW PSGs contributed to this success. The PSGs were a unique contribution of the project, playing a critical role in improving care-seeking in project districts. Effective implementation of iCCM should therefore include CHW management and social support mechanisms. Finally, re-analysis of national survey data improved evaluation findings by providing impact estimates.
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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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The evidence base for differentiated care for stable patients has grown in recent years. There has been less attention, however, to developing differentiated models of care for patients with advanced or unstable HIV disease. Current clinical guidelines and policies regarding optimal packages of care... for high-risk patients give few or no recommendations about how, by whom, or where they should be delivered for optimal impact.
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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...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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We systematically reviewed Medline as well as the references of published review articles for relevant studies of adherence to multidrug treatment of both drug-susceptible and drug-resistant TB through February 3, 2018. We included randomized controlled trials (RCTs) as well as prospective and retro...spective cohort studies (CSs) with an internal or external control group that evaluated any adherence intervention and conducted a meta-analysis of their impact on TB treatment outcomes. Our search identified 7,729 articles, of which 129 met the inclusion criteria for quantitative analysis. Seven adherence categories were identified, including DOT offered by different providers and at various locations, reminders and tracers, incentives and enablers, patient education, digital technologies (short message services [SMSs] via mobile phones and video-observed therapy [VOT]), staff education, and combinations of these interventions.
https://doi.org/10.1371/journal.pmed.1002595
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Rabies is a global public health problem with important socioeconomic impacts. Human rabies is preventable; almost all cases are transmitted through the bite of a rabid dog. Elimination of human rabies is possible. Technical support and tools are available. This report covers:
- Why investment ...is needed: key rationale.
- Investment purpose: global elimination of rabies.
- Investment in action: four case examples in Philippines, Kwa-Zulu Natal, South Africa, United Republic of Tanzania, Bangladesh.
- Summary results of case examples: Programme similarities and differences, and Health impact success stories from case examples.
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Ethiopia met the MDG target for drinking water access with a unique and high degree of success. The magnitude of the country’s success in providing improved drinking water to nearly half of its population in 25 years despite its diversity, size, and challenges cannot be overstated. This case study... documents the progress of the Ethiopian WASH sector from 1990 to 2015, and analyzes the impact of local systems created in Ethiopia to respond to water and sanitation challenges.
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Nationally, Senegal met the MDG target for water supply access. It did this by engaging the public and private sectors to effectively invest and report on investments. It focused on larger population centers, less on remote regions of the country. Its achievements set the stage for more equitable an...d widespread service provision as the country now works to achieve the SDGs, requiring sustainable management of universal access. This case study documents the progression of the sector between 1990 and 2015, and analyzes the impact of local systems created in Senegal to respond to the water and sanitation challenge.
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Democratic dispensation in 1994 created a political and social platform that reshaped life in South Africa. There was a surge in common belief that the inequity and wrong of Apartheid should and could be rectified. Equity of access to water and sanitation were obvious targets for improvement. In 199...4, an estimated 14–15 million South Africans were without access to an improved water supply, while close to 21 million - more than half of the population at that time - did not have access to improved sanitation facilities. These problems were most severe in poorer rural areas. The water and sanitation sector became unified by the vision of universal access for all South Africans. This case study documents the progression of the sector between 1994 and 2016, and analyzes the impact of local systems created in South Africa to respond to the water and sanitation challenge.
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Final Evaluation
The project objectives were to promote the conservation, sustainable use and cultivation of endangered medicinal plants in Zimbabwe, by demonstrating effective models at the local level, and developing a legal framework for the conservation, sustainable use, and equitable shari...ng of benefits from medicinal plants at the national level. After one year of implementation, the project rationale, indicators and targets were reviewed in order to make them more rigorous as per the new GEF focus on project impact. New indicators and targets were developed in December 2004. The project is composed of five closely linked output areas that have been allocated to different implementing partners to take a lead in. These include the National Herbarium and Botanical Gardens (Output 1), the University of Zimbabwe School of Pharmacy (Output 2), the Southern Alliance for Indigenous Resources (SAFIRE), a regional NGO (Output 2 and 4), and the Attorney General‟s Office (Output 5).
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This publication presents guidance on good practice from the Ayeyarwaddy Delta in Myanmar, outlining the key factors which contributed to the successful implementation and outcome of a range of community-based Disaster Risk Reduction initiatives implemented by the Myanmar Consortium for Community Re...silience (MCCR).
The content was developed over a period of two months between November-December 2015, involving a desk review of MCCR project documents including impact studies, monitoring reports and newsletters. Field visits were undertaken to the Ayeyarwaddy Delta to document the perspectives of key stakeholders at community level, including a total of 93 adults (men and women) and 57 children (girls and boys) from eight communities targeted under the DIPECHO IX project.
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This assessment is the first of its kind to be conducted in the south-eastern region of Myanmar. It is an important contribution to ensuring the full inclusion of women and children in Myanmar’s political, social, and cultural systems, with a specific focus on the issue of gender-based violence (G...BV) and its impact on these groups in south-eastern Myanmar. The United Nations Population Fund (UNFPA) is grateful for the participation of women, men, boys and girls from Mon, Kayin and Kayah States for sharing their views and experiences during the study.
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Thailand is exposed to flooding, landslides, drought, earthquakes, tsunamis, heat waves, forest fires, and epidemics. Thailand is also exposed to technological hazards such as chemical accidents. Flooding is the natural hazard with the most significant impact on human life, livelihoods, and the econ...omy for the country. The occurrence of droughts has increased in recent years due to the effects of the El Niño-Southern Oscillation (ENSO) cycle, which brings drier-than-average rainfall conditions. Drought has adversely impacted the country’s agriculture sector, which employs around one third of the country’s workforce.
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Policy Guidance Brief 2
• The potential health risks from climate change include: increase of waterborne and vector-borne diseases, heat-related illnesses, injuries and deaths, food insecurity and increased malnutrition. The poor, women, children and the elderly, as well as communities living... in remote high-risk areas are most vulnerable.
• The expected results to achieve this outcome are: (i) climate risk management system is well-established, robust and nationally integrated to respond efectively to increased intensity and impact of risks and hazards on people’s health and wellbeing; (ii) improved social protection, gender consideration and risk finance capacity to prepare for and recover from potential loss and damage resulting from climate change; (iii) Myanmar’s health system is improved and can deal with climate-induced health hazards and support climate-vulnerable communities to respond effectively to disaster and health hazards from climate change.
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