This study highlights the challenges and areas in need of improvement as perceived by CHWs and beneficiaries, in regards to a nationwide scale-up of CHW interventions in a resource-challenged country. Identifying and understanding these barriers, and addressing them accordingly, particularly within ...the context of performance-based financing, will serve to strengthen the current CHW system and provide key guidance for the continuing evolution of the CHW system in Rwanda.
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Health Systems for Outcomes Publication | Using qualitative data from Rwanda, this study focuses on four institutional factors that affect health worker performance and career choice: incentives, monitoring arrangements, professional norms and health workers’ intrinsic motivation. It also provides... illustrations of three institutional innovations that work, at least in the context of Rwanda: performance pay, the establishment of community health workers and increased attention to the training of health workers.
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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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CBM’s approach is based on the principles of the UN Convention on the Rights of Persons with Disabilities (CRPD) and on CBM’s responsibility to promote accessibility and the principles of universal design in all spheres of its work, including CBM’s digital content and communications. With this... toolkit, we want to provide a guide and practice resource to people working with and for CBM so that together we produce accessible digital content and communications, and place accessibility at the centre of our Information and Communication Technologies (ICT) procurement processes. The toolkit contains a selection of tools for producing accessible content in electronic documents, videos, figures and tools to ensure web accessibility. It also provides tools and information for accessible ICT procurement including tips and resources on how to communicate CBM’s accessibility requirements for products and services being purchased; and how to evaluate what providers promise and deliver.
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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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The objective of this Security Guideline for People with Albinism is to provide concrete and specific advice to people with albinism as well as those working with them, to remain safe within the context of where they live. It also provides easy to implement steps in handling an incident and swiftly ...mobilize useful resources to try and return a victim back to safety.
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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 learning report attempts to understand the drivers for, and barriers to, effective implementation as well as review the experiences of Start Fund members in responding to these outbreaks to support evidence-based decision-making within the Start Network at project, crisis, and system level. Spe...cifically, it analyses the effectiveness, efficiency, and relevance of Start Fund disease outbreak responses by reviewing and analysing funding, decision-making and response activities before ultimately exploring implications and recommendations.
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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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The purpose of this report is to provide an overview of the issues in regulating and managing international emergency in a selection of large and small-scale sudden onset disasters (SODs). In doing so, it aims to contribute to several key international commitments as well as its objective in disaste...rs and emergencies to “reduce the consequences the event may have on world health and its social and economic implications”.
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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).
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Technical report
This manual aims to provide information about the methods for investigating outbreaks of hepatitis E, and measures for their prevention and control. In addition, the manual gives information about the causative agent – known as the hepatitis E virus (HEV) – its epidemiology..., clinical manifestations of the disease and diagnosis.
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Une fois adoptée et mise en œuvre, la stratégie contribuera à réduire sensiblement les nouvelles infections sexuellement transmissibles et les décès connexes (ainsi que les mortinatalités et le cancer du col de l’utérus), tout en améliorant la santé individuelle, la santé sexuelle des ...hommes et des femmes, et le bien-être de tous. Elle va orienter les efforts visant à : accélérer et cibler l’essentiel des actions de prévention en renforçant des approches à la fois comportementales, biomédicales et structurelles ; faciliter l’accès individuel à l’information concernant le statut personnel vis-à-vis des infections sexuellement transmissibles ; améliorer l’accès au traitement et à l’éventail complet des soins de longue durée, le cas échéant ; et combattre la stigmatisation et la discrimination généralisées. Le projet de stratégie encourage une démarche centrée sur la personne et fondée sur les principes des droits fondamentaux, de l’égalité entre les sexes et de l’équité en santé.
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These National Operational Guidelines for Viral Load Testing detail how routine viral load testing will be implemented at the facility level in India. They include frequency and interpretation of monitoring, sample collections, storage and transportation, receipt of results, adherence counseling, an...d reporting requirements. Roles and responsibilities are outlined as well as turnaround time requirements.
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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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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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