A Focus on the Journey to Self-Reliance for Preventing Child and Maternal Deaths . June 2018
The 2018 Acting on the Call report focuses on 25 countries’ journeys to self-reliance for preventing child and maternal deaths. Self-reliance is a country’s ability to finance and implement solution...s to its own development challenges. Understanding where countries lie on this effort - known as the journey to self-reliance - helps USAID to best partner with countries and support their efforts.
The report looks at the health status of 25 priority countries as well as the current capacity of the health system to meet the needs of women and children. In the report, we recount progress since the 2012 Call to Action as well as identify gaps in order to inform future programming and areas that need strengthening during the journey to self-reliance. For the first time ever, we’ve calculated the return on our investment to eliminate bottlenecks to improving health services.
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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 health emergency preparedness, timely response and post disaster recovery and mitigati...on are in place at the national, district, health facility and community levels in Rwanda.
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The Rwandan Health Sector Research Policy (HSRP) policy defines the scope of research in the Rwandan health sector and presents the strategic principles to ensure that the research done in Rwandan health sector will be conducted in a more coordinated manner, promoting research for equity and social ...justice and to benefit the Rwandan community as well as the global community in general. The health sector research policy provides solutions to the challenges which have been identified in health research. It will support and improve Rwanda’s health research environment and create a space and framework in which health research will grow and support improved health outcomes in Rwanda. It gives a clear orientation for dissemination and use of results. For sustainability of health research in Rwanda, foreign researchers are called upon to collaborate with Rwandans with clear capacity building plans.
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Nepal has performed exceptionally in improving reproductive, maternal and child health outcomes over the past two decades. In this article, we discuss these achievements and outline a vision for the future of maternal, newborn and child survival in Nepal after the era of the Millennium Development G...oals. On the pathway towards quality universal health care services for all, we propose strengthening of health information systems, gradual health system reforms, improvement of existing facility based services, development of integrated service delivery models, improved technical and managerial capacity at district and facility levels. Elimination of all preventable causes of maternal, newborn and child deaths in Nepal should be our collective aspirational goal.
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Update - 27 June 2018
During the reporting week, the monsoon rains brought 252 mm of rainfall compared to 95 mm during the previous week. The downpour caused 65% of the week’s weather-related incidents (i.e. landslides, wind-storms and floods). Three rain gauges were installed in Chakmarkul (...near Camp 21), Camp 16 and Kutupalong, complementing existing rain gauges in Cox’s Bazar and Teknaf, as well as the Meteorological Station installed by Samaritan Purse in Camp 12. This network of rain gauges provides localized rainfall data at regular intervals throughout the day, which will allow the humanitarian community to better monitor, anticipate and respond to developments within the camps. Relocation of families at risk of landslides and flooding continued; a total of some 200 families have already moved to Camp 20 Extension and more than 100 families to Camp Extension 4. Repair of access roads, culverts, bridges and infrastructure is ongoing with continued attention to preparing for further heavy rains.
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Review of International, Regional and National Policies and Legal Frameworks that Promote Migrants and Mobile Populations' Access to Health and Malaria Services in the Greater Mekong Subregion (Cambodia, Lao People's Democratic Republic, Myanmar, Th...ailand and Viet Nam)
Migrants and mobile populations face many obstacles in accessing equitable essential health care services due to factors such as living and working conditions, education level, gender, irregular migration status, language and cultural barriers, anti-migrant sentiments, and lack of migrant-inclusive health policies among others. Despite significant progress having been made in the context of malaria control in the Greater Mekong Subregion (GMS), human movements can impact malaria transmission patterns and potentially introduce drug-resistant parasites. This legal framework review therefore serves as a guidance document on approaches to address malaria and malaria elimination for migrant and mobile populations (MMPs) in five countries of the GMS.
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Advances have been made through expanded interventions delivered through five public health approaches: innovative and intensified disease management; preventive chemotherapy; vector ecology and management; veterinary public health services; and the... provision of safe water, sanitation and hygiene. In 2015 alone nearly one billion people were treated for at least one disease and significant gains were achieved in relieving the symptoms and consequences of diseases for which effective tools are scarce; important reductions were achieved in the number of new cases of sleeping sickness, of visceral leishmaniasis in South-East Asia and also of Buruli ulcer.
The report also considers vector control strategies and discusses the importance of the draft WHO Global Vector Control Response 2017–2030.
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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 Rwanda on child health outcomes. The authors find that the incentives had a large and significant effec...t 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 .
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Health Systems for Outcomes Publication | This report summarizes the findings of a qualitative study on health workers’ performance and career in Rwanda to identify bottlenecks, strengths and shortcomings for human resources in the health sector, as perceived by both health workers and users of he...alth services.
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Through public-private partnerships, the government of Rwanda can make more efficient use of public resources by targeting and meeting the needs of specific populations and thus help ensure family planning services and products will be available to ...all Rwandans in the long term. This report aims to inform stakeholders working to strengthen family planning through multisectoral partnerships about Rwanda’s family market.
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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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We systematically reviewed Medline as well as the references of published review articles for relevant studies of adherence to multidrug treatment of both drug-susceptible and drug-resistant TB through February 3, 2018. We included randomized controlled trials (RCTs) as well as prospective and retro...spective cohort studies (CSs) with an internal or external control group that evaluated any adherence intervention and conducted a meta-analysis of their impact on TB treatment outcomes. Our search identified 7,729 articles, of which 129 met the inclusion criteria for quantitative analysis. Seven adherence categories were identified, including DOT offered by different providers and at various locations, reminders and tracers, incentives and enablers, patient education, digital technologies (short message services [SMSs] via mobile phones and video-observed therapy [VOT]), staff education, and combinations of these interventions.
https://doi.org/10.1371/journal.pmed.1002595
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A treatment literacy guide for pregnant women and mothers living with HIV
Positive Health, Dignity and Prevention for Women and their Babies is intended for use by networks of women living with HIV, women’s groups, peer educators and others wishing to help guide women living with HIV t...hrough the decisions they will need to take before, during and after their pregnancy. It is not intended as a substitute for going to a health facility and seeking information from a healthcare worker.
The facilitator’s manual and flipchart are intended to be used by leaders of support groups, peer educators or lay counsellors to facilitate small groups or community sessions with women living with HIV. Together, they provide accurate and comprehensive information to enable pregnant women and mothers living with HIV to know their rights and make informed decisions about their health, and the health of their baby.
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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 pe...ople living with HIV. Indeed, long centred around the 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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UNICEF CHILD ALERT May 2018
As part of a UNICEF series highlighting the challenges faced by children in current crisis situations, this Child Alert examines the situation of children affected by violent conflict in Kasai region, Democratic Republic of the Congo. The alert outlines what UNICEF a...nd its partners have achieved to date in providing humanitarian assistance to children in Kasai affected by malnutrition and lack of access to health care, safe water and education. It calls upon all parties to the conflict – and the international community – to take urgent action protecting the lives and futures of children at risk, before it is too late.
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This guideline consists of two main parts:
i.) Guidelines for Red Cross and Red Crescent national societies on how to start up and engage with other stakeholders in country in rolling out disaster risk reduction (DRR) education and awareness activities for children - not only in school, but also... in the community;
ii.) Games and activities to engage children with key lessons and messages to carry away. With a focus on Southeast Asia, cases from Viet Nam and Indonesia are highlighted.
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No publication year indicated
In the context of the floods in August 2015 in Myanmar, the Disaster Risk Reduction Working Group (DRR WG) was requested to provide clear recommendations to the DMH (Department of Hydrology and Meteorology)to strengthen preparedness activities, in particular for t...he next Monsoon season. UNDP as the lead of the DRR WG’s Policy Technical Task force carried out a desk review on EW (Early Warning) from all the DRR WG’s members at national and community levels. The document synthesizes the received information related to baseline surveys, lessons learned from the 2015’s floods, studies, project documents and initial recommendations on EW. Those serve as a base to this analysis and its overall recommendations.
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The BRACED Myanmar Alliance was a three-year project aiming to ‘build the resilience of 350,000 people across Myanmar to climate extremes’. The project worked in 7 states, 8 townships and 155 communities. The main impact for project populations was intended to be ‘improved well-being and reduc...ed loss and damage despite climate shocks’, and the project sought to do this by addressing immediate hazard-related needs at community level while encouraging longer-term solutions driven and delivered by communities and subnational and national government.
Community Resilience Assessments (CRAs) were the first activities delivered as part of the project, and the list of community-identified needs became the basis from which local-level project interventions were selected. The selection typically involved an infrastructure requirement (linked to addressing a natural hazard, and sometimes shared between communities); a package of livelihood support (assets and trainings); capacity-building on climate change/resilience topics; and village savings and loans association (VSLA) support. A particular emphasis was placed on women’s empowerment, and leadership trainings and support to women’s self-help groups were provided.
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The National Strategic Plan is based on the following guiding principles:
1) Life-course approach: adolescence is a key decade in the course of life that influences the health outcomes later in life.
2) Comprehensive approach: It recognizes the cross cutting health and development needs o...f young people such as intentional and unintentional injuries and violence, SRH, HIV/AIDS, mental health, substance use, violence, substance use and substance use disorders, infectious diseases and common conditions.
3) Equity and rights-based approach: focusing on equitable access to services to all adolescents including vulnerable groups and the recognizing the need to move from aspirations to obligations in fulflling young people rights for the highest attainable standard of health.
4) Multisectoral approach: recognizing cognizant of the fact that holistic development of young people requires multisectoral approach involving education, social welfare.
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