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
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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 resource aims to provide relevant and practical guidance to DRR practitioners (policy and programme colleagues), on how to ensure inclusion -
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particularly of vulnerable groups - in Community-Based DRR (CBDRR) initiatives in Myanmar. It comprises an overall Framework for inclusive CBDRR and a number of tools/resources including: 1) a checklist for inclusion in the 7 steps of the CBDRR process, 2) a guideline for documenting inclusion, 3) a template for assessing inclusion and 4) a compendium of tools and guidelines relevant to inclusive CBDRR.
The Inclusive Framework and Toolkit for Community-Based DRR in Myanmar is a resource produced by the Myanmar Consortium for Community Resilience (MCCR), a consortium led by ActionAid, with ACF, HelpAge, Oxfam, Plan and UN-Habitat.
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Suicide is largely preventable. Unlike for many other health issues, the tools to significantly reduce the most tragic loss of life by suicide are available. With collective action to acknowledge and
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address this serious problem, as well as commitment to effective interventions, supported by political will and resources, preventing suicide globally is within reach. Importantly, it is a
national suicide prevention strategy that allows communities to come together, and begin to tackle suicide and the issues specific to their needs without stigmatization.
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The report underscores that sexual and reproductive health and rights are often the first to be sacrificed during epidemics
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and that the gains of the past decade must be protected. The report also makes it clear that scarce resources must be focused on the most marginalized women and girls, including sex workers, gender diverse people, women in prison and migrants and others without proof of employment or residence.
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The health sector In Ukraine is beginning to change in recent years. The sector, based on a system of health care (Semashko) originating from the Soviet Union, had been stagnant for many years. Rema
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rkably little had changed since Independence and the health care system is as of today still characterized by a very hierarchical and territorial system with large numbers of beds in institutional care settings. At the same time the Government of Ukraine has only limited resources available that are spread thin over the existing infrastructure
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This publication is intended for professionals training or practicing in mental health and not for the general public. The opinions
expressed are those of the authors
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and do not necessarily represent the views of the Editor or IACAPAP. This publication seeks to
describe the best treatments and practices based on the scientific evidence available at the time of writing as evaluated by the authors and may change as a result of new research. Readers need to apply this knowledge to patients in accordance with the guidelines and laws of their country of practice. Some medications may not be available in some countries and readers should consult the specific drug information since not all dosages and unwanted effects are mentioned. Organizations, publications and websites are cited or linked to illustrate issues or as a source of further information. This does not mean that authors, the Editor or IACAPAP endorse their content or recommendations, which should be critically assessed by the reader. Websites may also change or cease to exist.
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Ethiopia has been repeatedly affected by conflict, flooding, drought, and disease outbreaks in the past years. As of January 2024, the country is actively responding to the longest recorded cholera outbreak which started in August 2022, recurrent me
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asles outbreaks which started in August 2021, and the highest number of malaria cases reported since 2017. The El Niño phenomenon is expected to cause further havoc up to July 2024, by causing drought in some parts of the country, and flooding in others. Food insecurity due to lost harvest and livestock is aggravating already high malnutrition rates, negatively impacting morbidity and mortality.
The Health Cluster is closely collaborating with the Ministry of Health (MOH) to prepare for, prevent, and respond to public health emergencies by mobilizing resources to enable health partners to provide life-saving health services to vulnerable populations.
In an environment with ever-increasing needs and decreased funding, the below priorities for 2024 and 2025 have been identified: 1 Strengthen advocacy for longer-term, development funding to address root causes of recurrent disease outbreaks, including through the Humanitarian-Development-Peace Nexus 2 Advocate for increased access to quality health services, with a strong focus on:
sexual and reproductive health services (including for survivors of sexual and gender-based violence)
inclusion of people with disabilities, older people, and people living with HIV
remote populations through inclusion of Mobile Health Teams (MHT) as part of the health system 3 Standardize health services provided by Health Cluster partners through the implementation of Essential Health Care packages, aligned with existing MOH guidance, aimed at ensuring quality service delivery for affected populations, especially at community level 4 Strengthen quality of, and access to data for needs analysis and informed decision-making 5 Strengthen subnational coordination, with increased focus on zones and local health partners
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The study sought to understand the factors that facilitate women to adhere to treatment and return to health facilities for routine care from their own perspective. The researchers focused on Malawi
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, Uganda and Zambia, early adopters of the global guidance to provide lifelong treatment for pregnant women living with HIV (Option B+) and spoke to women living with HIV, healthcare workers and programme managers to discover which factors and practices show promise in supporting women to initiate and remain in care.
This study found that women living with HIV who access these services to prevent vertical transmission have a strong sense and understanding of what factors support their retention and how health facilities, the wider community and their friends and relations can best support them. This report shares their words to describe how it feels to walk in their shoes on the path of life long treatment.
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Updated with information on Ebola virus disease and Middle East respiratory syndrome coronavirus
A wide variety of health events ranging in severity may occur related to air transport, requiring di
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fferent responses or, perhaps, no response at all. The target audience for this guidance document includes the national focal points (NFP) for the IHR and public health authorities at PoE, as well as national aviation regulatory authorities, airport operators and personnel, aircraft operators, air crew and other stakeholders involved in air transport and emergency preparedness and response to public health events
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The COVID-19 pandemic has exposed the inadequacy of investments in public health, the persistence of profound economic and social inequalities and
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the fragility of many key global systems and approaches.
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This section provides general information on HCW and key elements of management procedures that are essential to know before developing a HCWM plan.
The emergence and transmission of zoonotic diseases are driven by complex interactions
between health, environmental, and socio-political systems.
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Human movement is considered
a significant and increasing factor in these processes, yet forced migration remains an
understudied area of zoonotic research–due in part to the complexity of conducting interdisciplinary
research in these settings.
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Rabies is a devastating and societally important zoonotic disease, which is transmitted principally to humans through the bite of infected dogs. This acute, progressive viral encephalitis has the highest case fatality of any infectious disease
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and kills tens of thousands of people annually, with children and impoverished communities being affected disproportionately.
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This report outlines the Ministry of Health’s National Health Research Agenda in which it identifies research priorities in health. It will be im
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plemented in the same time frame as the Health Sector Strategic Plain 2012-2018. The Ministry of Health being the implementing agency of this document, is calling upon all partners, relevant ministries, higher learning institutions, students, development partners, etc to embrace this research agenda and ensure that researches conducted in Rwanda address priority areas identifies.
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The report reflects on the trends, achievements and challenges in global health over the past decade during which Dr Margaret Chan has been Director-General of WHO. It discusses the role of WHO in d
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ealing with such issues as the rise of noncommunicable diseases, leaps in life expectancy, and emerging threats like climate change and antimicrobial resistance.
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The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health-
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and poverty-related Sustainable Development Goals (SDGs) unless they take urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 2030, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
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The EHSP in Botswana seeks to attain universal coverage of high-quality package of essential health services. The EHSP is an integrated collection of cost-effective interventions, promotive, preventive, curative,
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and rehabilitative, that address the main diseases, injuries and risk factors that affect the population. The EHSP has two key purposes:
1) Provide a standardized package of basic services which forms the core of service delivery in all primary health care facilities
2) Promote a redistribution of health services by providing equitable access, especially in underserved areas, population, etc.
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The purpose of this strategy is to guide the planning, management and development of human resources for health in Rwanda for the period 2011 - 2016. The overall aim of the plan is to increase the n
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umber of appropriately skilled, motivated and equitably distributed health service providers for Rwanda.
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This document aims to assist policy‑makers, health care providers and researchers to understand key concepts in health ethics
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and to identify basic ethical questions surrounding health and health care. It illustrates the challenges of applying ethical principles to global public health and outlines practical strategies for dealing with those challenges.
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Primary care - Putting people first: This chapter describes how primary care brings promotion and prevention, cure and care together in a safe, effective
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and socially productive way at the interface between the population and the health system.
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