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This policy will serve as a cornerstone from which to address the accessibility of Family Planning services and to encourage its integration with services
...
for HIV/AIDS, maternal health, child health, and other development initiatives. This policy is timely, as Rwanda is embarking on the introduction of community-based provision of Family Planning through community health workers. In addition, the expansion of adolescent sexual and reproductive health programs is a pillar of this policy that will help attract and retain the next generation of Family Planning users. These efforts are anticipated to trigger a paradigm change in the way Family Planning services are provided and accessed in order to contribute towards a healthy and productive Rwanda for all.
more
Mental disorders are a leading cause of the global burden of disease, and the provision of mental healt
...
h services in developing countries remains very limited and far from equitable. Using the Creditor Reporting System, we estimate the amounts and patterns of development assistance for global mental health (DAMH) between 2007 and 2013. This allows us to examine how well international donors have responded to calls by global mental health advocates to scale up evidence-based services. Although DAMH did increase between 2007 and 2013, it remains low both in absolute terms and as a proportion of total development assistance for health (DAH). The average annual DAMH between 2007 and 2013 was US$133.57 million, and the proportion of DAH attributed to mental health is less than 1%. Approximately 48% of total DAMH was for humanitarian assistance, education, and civil services. More annual DAMH was channelled into the nonpublic sector than the public sector. Despite an expanding body of evidence suggesting that sustainable mental health care can be effectively integrated into existing health systems at relatively low cost, mental health has not received significant development assistance.
more
This document provides an overview of strategic purchasing of nutrition services within primary health
...
care. It introduces key terms and payment methods for countries to use in preparing to transform their health financial systems to scale up nutrition services. It does so by introducing nutritional perspectives to strategic health purchasing core areas: What to buy, From whom to buy and How to buy.
more
Uganda hosts approximately 1.1 million refugees making it Africa’s largest refugee hosting country and one of the five largest refugee hosting countries in the world. Most recently, throughout 2016- 2018, Uganda was impacted by three parallel emer
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gencies from South Sudan, the Democratic Republic of the Congo (DRC), and Burundi. In view of the on-going conflicts and famine
vulnerabilities in the Great Lakes Region, more refugee influxes and protracted refugee situations are anticipated in the foreseeable future. The unprecedented mass influx of refugees into Uganda in 2016-2018 has put enormous pressure on
the country’s basic service provision, in particular health and education services. Refugees share all social services with the local host communities. The refugee hosting districts are among the least developed districts in the country, and thus the additional refugee population is putting a high strain on already limited resources.
more
The report identifies major global gaps in WASH services: one third of health care facilities do not have what is needed to clean hands where care
...
is provided; one in four facilities have no water services, and 10% have no sanitation services. This means that 1.8 billion people use facilities that lack basic water services and 800 million use facilities with no toilets. Across the world’s 47 least-developed countries, the problem is even greater: half of health care facilities lack basic water services. Furthermore, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning.
This report also describes the global and national responses to the 2019 World Health Assembly resolution on WASH in health care facilities. More than 70% of countries have conducted related situation analyses, 86% have updated and are implementing standards and 60% are working to incrementally improve infrastructure and operation and maintenance of WASH services. Case studies from 30 countries demonstrate that progress is being propelled by strong national leadership and coordination, use of data to direct resources and action, and the mutual benefits of empowering health workers and communities to develop solutions together.
more
This survey is part of a series of eight country surveys conducted in the context of the People that Deliver Initiative (peoplethatdeliver.org). Th
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is global initiative, which brings together the world’s largest organizations, aims to improve health services performance through the professionalization of logistics managers.
more
During the implementation of the National Strategic Plan 2009–2012 on HIV and AIDS, Rwanda has continued its progress towards universal access to HIV and AIDS services. The new HIV and AIDS Nation
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al Strategic Plan July 2013–June 2018 (thereafter referred to as ‘the NSP’) presented here is set on pursuing the same objective, with inspiration from the global targets of “zero new HIV infections, zero HIV-related deaths and zero stigma and discrimination due to HIV”.
more
The goal of this contingency plan for El Nino related epidemics is to contribute to the reduction in mortality and morbidity associated with El Nino epidemic threats by ensuring that appropriate systems to support
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health emergency preparedness, timely response and post disaster recovery and mitigation are in place at the national, district, health facility and community levels in Rwanda.
more
In recent years, Rwanda has been on the fast track to achieve major health improvements for its entire population. With the support of government agencies and various non-governmental partners, the
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Ministry of Health (MoH) has endeavored to decentralize Rwanda’s health system and bring health services closer to the people. Guided by multitude of national and international development frameworks, Rwanda’s healthcare successes include the establishment of a community health insurance scheme (mutuelle de santé), a system of cooperative-financed community health workers in every village, and interventions for researching, preventing, and treating diseases like HIV/AIDS, TB, and malaria.
As the MoH continues to design innovative means to reach and surpass its prescribed health outcome targets, it will hold as core principles the integration of service provision, the increase in healthcare capacity, and the attainment of sustainable funding sources. Rwanda is committed to achieving the Millennium Development Goals by 2015 and has declared Family Planning (FP) a national priority for poverty reduction and socioeconomic development of the country. Modern contraceptive use has more than quadrupled from 2005 to 2010, rising from 10% to 45%, but the government’s Economic Development and Poverty Reduction Strategy calls for an increase the modern contraceptive prevalence to 70% by 2016. While structural changes in health care and supply chains have led to noteworthy improvements in FP and other services, there are still many challenges that must be overcome. As such, a strategic plan is needed to coordinate FP efforts around a well-defined set of objectives and responsibilities.
more
The National Strategic Plan for HIV/AIDS and STIs 2017-2024 spells out the objectives and targets that we have jointly committed to achieve. The plan describes the strategies and activities that will need to be implemented on the ground across India's 36 States and Union Territories with the help
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of AIDS Control Societies, District AIDS Prevention and Control Units, Regional Institutes, communities, development partners and the private sector. We must urgently scale up our efforts to avert new HIV infections and provide care and treatment to people living with HIV to materialise our commitment of ending AIDS in India by 2030.
more
A key purpose of the Recovery Toolkit is to support countries in the reactivation of health services
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which may have suffered as a result of the emergency. These services include ongoing programmes such as immunization and vaccinations, maternal and child health services, and noncommunicable diseases.
more
Globally, approximately 56.8 million people are in need of palliative care
services; 78% of them living in low and middle-income country yet only
...
about 12% have their needs being met causing great suffering for many.
more
The application of digital health technology is growing at a rapid rate in Africa, with the goals of improving the delivery
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of healthcare services and more effectively reaching out to remote and underserved communities. The lack of enabling guidelines and standards across the continent, on the other hand, makes it difficult to share data in a meaningful way across the continent.
Considering this, Africa Centres for Disease Control and Prevention (Africa CDC) established a task force of 24 members to provide expertise and guidance in the development of AU HIE guidelines and standards. Members of the task force were subject matter experts working in Africa and internationally on the collection, analysis, and exchange of health information. Some of these experts had been involved in previous consultations on defining Africa CDC’s health information systems strategy. A chairperson, co-chairperson, and secretary were elected to engage the task force members in different technical working groups.
more
Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community
...
health workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
more
The 2007 Rwanda Service Provision Assessment (RSPA) was a national representative survey conducted in 538 health facilities throughout Rwanda. The survey covered hospitals, health centers, dispensar
...
ies and
health posts, including all public facilities such as government and government-assisted health facilities. The 2007 RSPA used interviews with health service providers and clients and observations of provider client consultations to obtain information on the capacity of facilities to provide quality services and the existence of functioning systems to support quality services. The areas addressed were the overall facility
infrastructure, maternal and child health, reproductive health, tuberculosis, malaria services; and services for sexually transmitted infections and HIV/AIDS. The objective was to assess the strengths and
weaknesses of the infrastructure and systems supporting these services, and to assess the adherence to standards in the delivery of services.
more
Rehabilitation in health systems provides recommendations for Member States and other relevant stakeholders to strengthen and expand the availability of quality rehabilitation
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services. Currently, there is a significant unmet need for rehabilitation services and it is frequently undervalued in the health system. As populations age and the prevalence of noncommunicable diseases and injuries increases, and the demand for rehabilitation grows, strengthening rehabilitation in health systems becomes ever more paramount.
more
Health System Review: Achievements and Challenges
Tangcharoensathien, Viroy; Patcharanarumol, Walaiporn; Panichkriangkrai, Warisa
World Health Organization (WHO)
(2016)
C_WHO
Policy Note: Thailand Health Systems in Transition
By 2002, Universal Health Coverage was achieved through three public insurance schemes: the Civil Servant Medical Benefit Scheme (CSMBS) for civ ... il servants and their dependents, Social Health Insurance (SHI) for formal sector employees, and the Universal Coverage Scheme (UCS) for the remainder of the population.
The establishment of these three schemes has changed the way health care is financed. A supply-led system, under which all Ministry of Public Health (MOPH) health facilities received an annual budget allocation from the MOPH, has now been completely replaced by a system in which the three public purchasers - separated through a purchaser-provider split - manage a demand-led system of financing. more
By 2002, Universal Health Coverage was achieved through three public insurance schemes: the Civil Servant Medical Benefit Scheme (CSMBS) for civ ... il servants and their dependents, Social Health Insurance (SHI) for formal sector employees, and the Universal Coverage Scheme (UCS) for the remainder of the population.
The establishment of these three schemes has changed the way health care is financed. A supply-led system, under which all Ministry of Public Health (MOPH) health facilities received an annual budget allocation from the MOPH, has now been completely replaced by a system in which the three public purchasers - separated through a purchaser-provider split - manage a demand-led system of financing. more
Full eHandbook under: http://www.msh.org/resources/health-systems-in-action-an-ehandbook-for-leaders-and-managers
Effective supply management has the potential to make a powerful contribution to the reliable availability
...
of essential medicines, which are a crucial part of the delivery of highquality health care services. Because medicines are costly and poor management so often results in waste, good supply management is also crucial to the cost-effectiveness of providing medicines.
more
Policy Research Working Paper 6100 | Impact Evaluation Series No. 60 | This study examines the effect of performance incentives for health care providers to provide more and higher quality care in R
...
wanda on child health outcomes. The authors find that the incentives had a large and significant effect on the weight-for-age of children 0–11 months and on the height-for-age of children 24–49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill .
more
Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in d
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isease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expanding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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