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 2011 update of Guidelines for the programmatic management of drug-resistant tuberculosis is intended as a tool for use by public health professionals working in response
to the Sixty-second World Health Assembly’s resolution on prevention and control of multidrug-resistant tuberculosis and e...xtensively drug-resistant tuberculosis.
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Antimicrobial resistance (AMR) is described as a situation when bacteria, viruses, fungi and parasites
change over time and no longer respond to medicines, making infections harder or impossible to treat,
and increasing the risk of disease spread, severe illness and death.1 AMR in recent years has... become
a global priority in public health due to its widespread consequences and increasing occurrence from
time to time. AMR has a formidable impact where the existing antibiotics and other antimicrobial
medicines become ineffective, and infections become increasingly difficult or impossible to treat.
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May 2018
HIV i-Base
ISSN 1475-2077 www.i-Base.info
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You and your doctor Resistance and adherence Treatment choices
This implementation plan sets out a series of programmatic objectives, activities and outcomes for malaria surveillance strengthening in Myanmar over the next two years. This period represents a key phase as the National Malaria Control Programme (NMCP) strives to build on recent achievements in str...engthening core surveillance operations.
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Cervical cancer continues to be a significant public health problem and a major cause of premature mortality among women, disproportionately affecting the socioeconomically disadvantaged population in low- and middle-income countries (LMICs). In the absence of implementing the known evidence-based, ...cost-effective interventions, the number of deaths per year is projected to reach approximately 416 000 globally in 2035. It was estimated in 2020 that 32% of incident cervical cancer cases and 34% of cervical cancer deaths in the world occurred in the 11 Member States of the WHO South-East Asia (SEA) Region. In 2020, 190 874 new cases and 116 015 deaths were estimated due to cervical cancer, which is the third commonest cancer in the Region
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These consolidated guidelines on HIV testing services (HTS) bring together existing and new guidance on HTS across different settings and populations.
The World Health Organization (WHO) first released consolidated guidelines on HTS in 2015, in response to requests from Member States, national pr...ogramme managers and health workers for support to achieve the United Nations (UN) 90–90–90 global HIV targets – and specifically the first target of diagnosing 90% of all people with HIV. In 2016, based on new evidence, WHO released a supplement to address important new HIV testing approaches – HIV self-testing (HIVST) and provider-assisted referral.
Since the release of 2015 and 2016 HTS guidelines, new issues and more evidence have emerged. To address this, WHO has updated guidance on HIV testing services. In this guideline, WHO updates recommendation on HIVST and provides new recommendations on social network-based HIV testing approaches and western blotting (see box, next page). This guideline seeks to provide support to Member States, programme managers, health workers and other stakeholders seeking to achieve national and international goals to end the HIV epidemic as a public health threat by 2030.
These guidelines also provide operational guidance on HTS demand creation and messaging; implementation considerations for priority populations; HIV testing strategies for diagnosis HIV; optimizing the use of dual HIV/syphilis rapid diagnostic tests; and considerations for strategic planning and rationalizing resources such as optimal time points for maternal retesting
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UN, international agencies and experts released a groundbreaking report demanding immediate, coordinated and ambitious action to avert a potentially disastrous drug-resistance crisis.
If no action is taken - warns the UN Ad hoc Interagency Coordinating Group on Antimicrobial Resistance who release...d the report – drug-resistant diseases could cause 10 million deaths each year by 2050 and damage to the economy as catastrophic as the 2008-2009 global financial crisis. By 2030, antimicrobial resistance could force up to 24 million people into extreme poverty.
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N Engl J Med 2018; 378:577-579; DOI: 10.1056/NEJMc1711583
A dose of oral vaccine provides effective short-term protection against cholera during an outbreak, a study in Zambia shows.
According to researchers, a shortage in the global stockpile of cholera vaccines meant that single-dose oral vacc...ination was necessary to tackle an outbreak in Lusaka, Zambia, in February 2016. The emergency vaccination campaign was implemented in April 2016, targeting more than 500,000 people in Lusaka’s overcrowded township areas.
The 2016 outbreak happened when Zambia had not reported a case of cholera in four years.
To determine the effectiveness of the single-dose cholera vaccine, the researchers enrolled 66 patients with confirmed cholera and 330 people without the disease who were neighbours of the patients.
According to the study the effectiveness of the single dose vaccination was about 90 per cent.
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This Module, Count me in! Inclusive WASH in Ethiopia, was prepared by Ethiopian authors with support from The Open University UK. It was first published in June 2018. The contributors of original material are:Girma Aboma, Manager, GAA Economic Development ConsultBethel Shiferaw, SPCC Disability Incl...usion Advisor, Ethiopian Center for Disability and Development
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A National Service Programme for All Children with Special Needs and their Families
In Myanmar, we estimate that at least 40% of children require ECI services for short to longer periods of time. At present, 35.1% of Myanmar children are moderately to severely stunted; all of these children are l...ikely to have one or more developmental delays. In addition, at least 5% to 12% of the nation’s children will be identified to have disabilities, chronic diseases or atypical behaviours.
Over time, approximately 70% of the children who will be served will improve in their development, attain expected levels of development for their age, and will consolidate their gains within one to two years. Other children, approximately 30%, will have lifelong disabilities or other conditions, and ECI services usually greatly improve their development and help them to achieve their full potential.
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SCOPING QUESTION: In adults with established status epilepticus (i.e., seizures persisting after the first-line treatment with benzodiazepines [or benzodiazepines-resistant status epilepticus]), which anti-epileptic medications are associated with cessation of seizures and reduced adverse effects)?
...
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The Transformation Agenda (TA) ushered in an ambitious reform process intended to transform the World Health Organization (WHO) into an organization that is proactive, results-driven, accountable and which meets stakeholder expectations, towards transforming and improving public health services in t...he African Region. It aimed to achieve a WHO that is pro-results, which optimally and creatively targets technical work as well as make operations more responsive, with greater effectiveness in both communications and partnerships. The Africa Region has been the epicentre of the human immunodeficiency virus (HIV) epidemic and it’s one of the leading causes of disease and death on the continent. The WHO, with partners, has worked tirelessly for many years to control the threat and reduce the negative impact of the disease. Since the early 2000s, significant progress has been made in the global fight against the scourge of HIV. However, the WCA subregion was falling concerningly behind ESA on several key indicators of progress. In 2016, the WHO joined UNAIDS, UNICEF and other partners in a call for a strong and urgent response to support WCA countries to develop catch-up plans to triple and fast-track ART coverage, to enable the region to catch up with ESA by the end of 2020. Implementation of a widespread test-and-treat strategy, coupled with the scale-up of differentiated service delivery (DSD) and mobilization of requisite funding, accelerated WCA’s progress towards this goal. The HIV treatment catch-up and fast-track plan has achieved its target of seeing the West and Central African region (WCA) catch up with the Eastern and Southern African region’s (ESA) antiretroviral coverage rate of 78% in 2021, albeit later than the 2020 target time frame. A 33% improvement was achieved in WCA, against 21% in ESA, between 2015–2020. WCA achieved a significant 42% increase, compared to ESA’s 23%, between 2015 and 2021, to see WCA draw level with ESA at 78%. In the Democratic Republic of the Congo (DRC) alone, progress of up to 47% was observed between 2015 and 2020, for example. In addition, 1.6 million more People Living with HIV (PLHIV) were enrolled on antiretroviral treatment (ART) between 2015 and 2020.
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A WHO guide to inform & harmonize national & international pandemic preparedness and response
The main updates from the 2013 interim guidance are:
Alignment with other relevant United Nations policies for crisis and emergency management, and
Inclusion of the significant development in re...cent years of the strategies for pandemic vaccine response during the start of a pandemic.
The guide is available in English, Arabic, Chinese, French, Spanish and Russian
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The report offers an overview of the progress the humanitarian sector has made and the obstacles it has faced over the past 10 years. Accountability is no longer just a fashionable term, there is now a shared understanding of what it takes to be accountable. From changes at policy level, to concrete... actions taken in the field, this report documents this sector-wide shift. It also shows that being accountable to the people we aim to serve is not just the right thing to do, it is also the best way to ensure programmes are relevant, effective, efficient and sustainable
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It is estimated that more than 311 000 women die of cervical
cancer each year. Of these deaths, 91% occur in low- and
middle-income countries. Demographic changes and a lack of
action mean that the number of deaths per year is projected
to reach 460 000 by 2040.