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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R4D conducted a thorough desk review and qualitative fiscal space analysis, 19 interviews about financing for the three diseases and the extent of alignment between public financial management systems and health policy objectives, and a validation workshop with government officials.
Tanzania’...s disease response faces a triple transition challenge: replacing donor funding, closing the resource gap that would exist even with donor funding, and more efficiently delivering on disease response objectives.
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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...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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This publication provides guidance to governments, civil society organizations (nongovernmental organizations and community-based organizations) and other partners implementing HIV prevention, care and treatment programs with key populations. This guide is designed to assist these programs in the de...velopment of monitoring systems for frontline workers (such as peer outreach workers, staff outreach supervisors and program managers) to understand performance. It includes comprehensive tools and forms that various levels of staff can use to collect and analyze data to manage and improve a program.
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This working paper is a case study on South Sudan as an important refugee country of origin. The case study looks at issues of forced displacement in South Sudan and underscores the linkages between internally displaced persons and South Sudanese refugees. The case study highlights the importance of... understanding local contexts and root drivers of conflict and displacement. It reviews evaluations of programmes in South Sudan, including past efforts at state building and refugee resettlement to look at learning within the international community. The study was undertaken as part of a wider research project on learning from evaluations to improve responses to situations of forced displacement .
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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 ...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.
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Globally, it is estimated that 128.6 million people are currently in need of humanitarian assistance. Of these individuals, approximately one-fourth are women and girls of reproductive age. Although family planning is one of the most life-saving, empowering, and cost-effective interventions for wome...n and girls, it remains an overwhelming gap in emergency responses due to a lack of prioritisation and funding. Consequently, many women and girls are forced to contend with an unmet need for family planning and unplanned pregnancies in addition to the traumas of conflict, disaster, and displacement.
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The provision of safe and efficacious blood and blood components for transfusion or manufacturing use involves a number of processes, from the selection of blood donors and the collection, processing and testing of blood donations to the testing of patient samples, the issue of compatible blood and ...its administration to the patient. There is a risk of error in each process in this “transfusion chain” and a failure at any of these stages can have serious implications for the recipients of blood and blood products. Thus, while blood transfusion can be life-saving, there are associated risks, particularly the transmission of bloodborne infections.
Screening for transfusion-transmissible infections (TTIs) to exclude blood donations at risk of transmitting infection from donors to recipients is a critical part of the process of ensuring that transfusion is as safe as possible. Effective screening for evidence of the presence of the most common and dangerous TTIs can reduce the risk of transmission to very low levels.
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While the ratification of the Convention and its Optional Protocol has proceeded rapidly, knowledge on how to implement and monitor them has not kept pace. Conscious of this challenge, my Office has developed this Training Guide on the Convention and its Optional Protocol. It is complemented by eigh...t training modules, designed to inform and empower those who are involved in ratifying, implementing and monitoring the two instruments. While the Training Guide is mainly targeted at facilitators of training courses on the Convention and its Optional Protocol, it acknowledges that each and every one of us has a role to play. I recommend wide dissemination of the training package, and its use by all those who want to embark upon the essential journey towards greater awareness and effective implementation of the rights of persons with disabilities and, ultimately, the building of an inclusive society for all.
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This guide includes information relevant for tuberculosis (TB) program and laboratory managers, as well as Ministry of Health officials across disease programs interested in establishing integrated solutions for specimen referral. Though TB-focused in name, it offers integration-oriented assessment,... design, and monitoring guidance related to improving coordination and efficiency, and is relevant for other programs as well. Country case studies include viral load and early infant diagnosis (EID) in Uganda and EID in Ethiopia.
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This manual summarizes the methodology used to develop WHODAS 2.0 and the findings obtained when the schedule was applied to certain areas of general health, including mental and neurological disorders.
The manual will be useful to any researcher or clinician wishing to use WHODAS 2.0 in their prac...tice. It includes the seven versions of WHODAS 2.0, which differ in length and intended mode of administration. It also provides general population norms; these allow WHODAS 2.0 values for certain subpopulations to be compared with those for the general population.
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This document provides a systematic approach in developing a coordinated, standardized, reliable, efficient, cost-effective, and sustainable specimen transport and referral system to support IVHD and VL testing networks. This document provides technical and programmatic recommendations on the approp...riate specimen storage and transportation of specimens for HIV VL and IVHD testing. Along with the national guidelines for specimen storage and transport, these standards should provide guidance on the creation or improvement of specimen referral networks and specimen transport systems. In addition, standard operating procedures (SOPs) targeting drivers and persons responsible for packing of specimens and results return are included in this document.
No publication year indicated in the document.
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The International Classification of Functioning, Disability and Health, known more commonly as ICF, provides a standard language and framework for the description of health and health-related states. Like the first version published by the World Health Organization for trial purposes in 1980, ICF is... a multipurpose classification intended for a wide range of uses in different sectors. It is a classification of health and health-related domains -- domains that help us to describe changes in body function and structure, what a person with a health condition can do in a standard environment (their level of capacity), as well as what they actually do in their usual environment (their level of performance).
These domains are classified from body, individual and societal perspectives by means of two lists: a list of body functions and structure, and a list of domains of activity and participation. In ICF, the term functioning refers to all body functions, activities and participation, while disability is similarly an umbrella term for impairments, activity limitations and participation restrictions. ICF also lists environmental factors that interact with all these components.
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Maternal Child Nutrition. 2017;e12478
This paper analyzes individual level and household level determinants of anemia among children and women in Nepal and Pakistan. Applying multivariate modified Poisson models to recent national survey data, we find that the prevalence of anemia was significa...ntly higher among women from the poorest households in Pakistan (adjusted prevalence ratio [95% CI]: 1.10 [1.04–1.17]), women lacking sanitation facilities in Nepal (1.22 [1.12–1.33]), and among undernourished women (BMI < 18.5 kg/m2) in both countries (Nepal: 1.10 [1.00–1.21] and Pakistan: 1.07 [1.02–1.13]). Similarly, children in both countries were more likely to be anemic if stunted (Nepal: 1.19 [1.09–1.30] and Pakistan: 1.10 [1.07–1.14]) and having an anemic mother (Nepal: 1.31 [1.20–1.42] and Pakistan: 1.21 [1.17–1.26]).
https://doi.org/10.1111/mcn.12478
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This external performance evaluation of the Malawi Girls’ Empowerment through Education and Health Activity (ASPIRE), conducted 2.5 years after ASPIRE began, establishes the activity’s progress against its objectives, proposes adaptations for the final year, and captures lessons for application ...in future girls’ empowerment, health, and education programming in Malawi.
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Journal of the International AIDS Society 2017, 20(Suppl 4):21644
National AIDS Programme in Myanmar has made significant progress in scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living with HIV. Indeed, long centred around t...he hospital and reliant on physicians, the country's HIV response is undergoing a process of successful decentralization with HIV care increasingly being integrated into other health services as part of a systematic effort to expand access to HIV treatment. This study describes implementation of differentiated care in Médecins Sans Frontières (MSF)‐supported programmes and reports its outcomes.
https://doi.org/10.7448/IAS.20.5.21644
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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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USAID/Afghanistan’s $443 million investment in the Afghan Sustainable Water Supply and Sanitation (SWSS) activity is one of the Agency’s largest single investments in sustainable rural water supply delivery. The project installed about 2,123 wells with hand pumps across Afghanistan from 2009–2...012. This report presents findings from a retrospective evaluation of a random selection of wells with hand pumps installed under the SWSS project.
This evaluation’s key purpose is to identify factors that support and hinder sustainable water service delivery in different contexts.
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