Speaking at the 2015 CCIH Annual Conference, Dr. Alfonso Rosales, Maternal and Child Senior Advisor, World Vision International, examines a study in South Sudan involving illiterate community health workers, suggesting that a process to measure and maintain clinical skills of community health workers is an important element of program design.
Presented by Ghassan Karem.
Part of a session - 'Context, gender, and sustainability in introducing and scaling-up essential health care packages in fragile and crisis-affected countries' - at the Fifth Global Symposium for Health Systems Research in October 2018. The essential package of health services is a mechanism for expanding equitable coverage of primary health care and essential hospital services in countries recovering from conflict. The session explored the evidence-base on such healthcare packages in different contexts and prioritized areas for strengthening research.
This document summarizes research conducted in Uganda to improve health sector funding and accountability. Surveys found frequent stock-outs of essential malaria and antibiotic drugs in health clinics due to funding gaps, shortages, and procurement challenges. A separate survey of 9 districts found a lack of financial transparency and accountability, as well as distrust between civil society organizations and district leaders. However, the research resulted in increased health sector funding, a priority on essential medicines, and district plans to improve accountability. Advocacy efforts must frame issues in policy contexts and have clear targets, disseminate findings widely through partnerships, and continue follow-up efforts to create impact.
Investments in tuberculosis control in Rajasthan could provide significant benefits relative to costs. Modeling found that engaging private healthcare providers and providing subsidies for TB diagnosis and treatment could yield over 54,000 crore INR in benefits at a cost of 348.65 crore INR, resulting in a benefit-cost ratio of 156.4. Adding active case finding through mobile screening in urban slums could increase benefits to over 81,000 crore INR at an added cost of 783.07 crore INR, yielding a benefit-cost ratio of 104.7. While limitations exist, interventions to enhance private sector engagement and case finding could offer major returns through reduced transmission and lives saved from a disease that is largely curable.
Speaking at the 2015 CCIH Annual Conference, Dr. Alfonso Rosales, Maternal and Child Senior Advisor, World Vision International, examines a study in South Sudan involving illiterate community health workers, suggesting that a process to measure and maintain clinical skills of community health workers is an important element of program design.
Presented by Ghassan Karem.
Part of a session - 'Context, gender, and sustainability in introducing and scaling-up essential health care packages in fragile and crisis-affected countries' - at the Fifth Global Symposium for Health Systems Research in October 2018. The essential package of health services is a mechanism for expanding equitable coverage of primary health care and essential hospital services in countries recovering from conflict. The session explored the evidence-base on such healthcare packages in different contexts and prioritized areas for strengthening research.
This document summarizes research conducted in Uganda to improve health sector funding and accountability. Surveys found frequent stock-outs of essential malaria and antibiotic drugs in health clinics due to funding gaps, shortages, and procurement challenges. A separate survey of 9 districts found a lack of financial transparency and accountability, as well as distrust between civil society organizations and district leaders. However, the research resulted in increased health sector funding, a priority on essential medicines, and district plans to improve accountability. Advocacy efforts must frame issues in policy contexts and have clear targets, disseminate findings widely through partnerships, and continue follow-up efforts to create impact.
Investments in tuberculosis control in Rajasthan could provide significant benefits relative to costs. Modeling found that engaging private healthcare providers and providing subsidies for TB diagnosis and treatment could yield over 54,000 crore INR in benefits at a cost of 348.65 crore INR, resulting in a benefit-cost ratio of 156.4. Adding active case finding through mobile screening in urban slums could increase benefits to over 81,000 crore INR at an added cost of 783.07 crore INR, yielding a benefit-cost ratio of 104.7. While limitations exist, interventions to enhance private sector engagement and case finding could offer major returns through reduced transmission and lives saved from a disease that is largely curable.
The document discusses Afghanistan's experience monitoring basic health services contracts with NGOs in a conflict setting. It outlines Afghanistan's complex monitoring and evaluation (M&E) system involving multiple departments and organizations. Resources for M&E activities are substantial, with a third party responsible for most activities at a cost of $3.2 million per year. The relationship between contract managers and service-providing NGOs aims to improve performance through monitoring reports and meetings, though external factors sometimes interfere.
Implementation of bphsphc afghanistan experience august 2019Najibullah Safi
The document discusses Afghanistan's experience implementing the Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS) through contracting non-governmental organizations (NGOs) since 2003. Key points include:
1) NGOs deliver health services in 31 of 34 provinces through competitive bidding managed by the Ministry of Public Health. Services are financed through international donors.
2) The BPHS defines 7 elements of primary health care including maternal and newborn care, child health and immunization, public nutrition, communicable disease treatment and control, mental health, disability and rehabilitation, and essential drug supply.
3) Health indicators like immunization rates and access to maternal health
Investments in tuberculosis control programs in Andhra Pradesh, such as engaging private healthcare providers and active case finding in urban slums, could provide substantial health benefits and reduce transmission at relatively low costs. Modeling studies estimate that private sector engagement could yield over 51,000 crore INR in benefits with a cost of 460 crore INR, resulting in a benefit-cost ratio of over 112. Adding active case finding in urban slums could increase benefits to over 84,000 crore INR at a cost of 826 crore INR, with a benefit-cost ratio above 101. While limitations exist, expanded tuberculosis control efforts in Andhra Pradesh show potential to cost-effectively reduce disease burden.
Covid 19 continuation of essential health servicesNajibullah Safi
This document discusses strategies for sustaining non-COVID-19 essential health services in Afghanistan during the COVID-19 pandemic. It notes that health service utilization has decreased and some providers have been affected by COVID-19. WHO recommended 10 strategic actions including prioritizing essential services, optimizing service delivery, maintaining health workforce and supplies, and strengthening communication and monitoring. Afghanistan established coordination committees and continued providing basic health services while adapting delivery and establishing separate fever clinics. Monitoring was increased and digital platforms expanded to support essential service delivery during the pandemic. The impact on services was mixed but the response provided opportunities to strengthen capacity.
Maternal Mortality Estimates, Methods and ProcessesPAHO_RHO
This document discusses maternal mortality estimation methods used by the UN Maternal Mortality Interagency Group and issues with the consultation process. It describes how countries are categorized based on available data and how estimates are calculated for each group. Concerns raised include the inclusion of late maternal deaths, use of constant correction factors over time, and lack of transparency in methods. The document also reviews maternal mortality data reported by countries to PAHO and compares estimates from different sources.
Impact and cost effectivene of rotavirus vaccine introduction in afghanistanNajibullah Safi
This document provides a summary of a cost-effectiveness analysis of introducing rotavirus vaccination in Afghanistan. The analysis finds that vaccination would be highly cost-effective compared to no vaccination. It estimates that over 10 years, vaccination could avert over 1 million cases, 661,000 outpatient visits, 49,000 hospitalizations and nearly 12,000 deaths. The incremental cost per disability-adjusted life year averted is estimated to be $103-$59 depending on perspective, below Afghanistan's GDP per capita threshold for cost-effectiveness. Sensitivity analysis showed results were robust to varying parameters like disease burden and vaccine price. The document discusses limitations and next steps to support government adoption of vaccination.
This case study examines the costs of dementia in China from 1990 to 2030. It finds that the total annual costs of dementia in China increased from $0.9 billion in 1990 to $47.2 billion in 2010 and are predicted to reach $69.0 billion in 2020 and $114.2 billion in 2030. The costs were categorized as direct medical costs, direct non-medical costs, and indirect costs. Informal care accounted for over 90% of costs in 1990 and 2000. Population aging and increasing dementia prevalence are major drivers of rising costs, especially from 2010 to 2020. To reduce future costs, China needs an integrated health and social care system and prevention strategies.
Najibullah Safi, MD, MSc. HPM presented on the history and current state of Afghanistan's health care system. He discussed key progress made in health indicators like immunization coverage and under-five mortality. However, challenges remain such as high stunting rates, poor quality of care in hospitals, and a high maternal mortality ratio. Moving forward, Afghanistan aims to implement an Integrated Package of Essential Health Services to address the triple burden of diseases. Principles of the way forward include prioritizing the poor, increasing community engagement, and raising domestic financing for health.
The document describes India's Revised National Tuberculosis Control Programme (RNTCP) which was implemented in 1993 to address weaknesses in the previous NTP program since 1962 such as managerial issues, inadequate funding, overreliance on x-rays for diagnosis, and supply issues. The RNTCP uses the DOTS strategy which focuses on political commitment, quality-assured sputum smear microscopy for diagnosis, adequate supply of quality-assured drugs, directly observed treatment, and systematic monitoring in order to achieve at least 85% cure rates for infectious TB cases and detect at least 70% of estimated cases. The RNTCP is organized with State TB Offices, Demonstration Centers, District Centers, and microscopy and treatment centers
Minnesota’s accountable communities for health soder145
The document summarizes Minnesota's Accountable Communities for Health (ACH) grant program and lessons from its first year. It provides context on the federal State Innovation Model initiative and Minnesota's Accountable Health Model. It then describes the ACH program, which funds 15 community collaboratives to coordinate care and implement prevention strategies. It outlines ACH experiences and highlights data sources for the state's multi-year evaluation, including interviews that identified accomplishments, barriers, and lessons learned from grantees in the program's first year.
The document provides an agenda and information about an upcoming Meaningful Use Mini-Camp on October 21, 2015. The agenda includes introductions, an overview of the California Technical Assistance Program (CTAP), a review of the 2015-2017 Modification Final Rule, a discussion of challenging measures, and strategic planning for Meaningful Use. Additional details are then provided about CTAP funding, milestones, and payments. The document concludes with sections on enrollment in CTAP and an overview of some of the most challenging Meaningful Use measures.
The document summarizes the experience of scaling up HIV treatment in Cameroon through operational research. Cameroon implemented a public health approach to decentralize HIV treatment from central and regional hospitals to district hospitals between 2001-2005. This was supported by standardized treatment guidelines, subsidies for laboratory tests, and a mentorship strategy. Operational research evaluated the impact and found early outcomes were better at district levels, including improved access, quality of care, adherence, and patient perceptions of decentralization. However, challenges remain around sustained drug supply, prevention of unsafe sex, and health worker satisfaction.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: John F. Ryan, Director, European Commission, DG SANTE
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
Impact of voucher system on access to maternal and child health services in E...Jeff Knezovich
John Bua of Makerere University presents on a voucher scheme in Eastern Uganda to transport pregnant women to the care facility at iHEA 2011 in Toronto, Canada.
Georgia Basics: Evaluation Results from Five Years of Intervention for Risky Drinking and Substance Use in Urban Emergency Departments
Presented by:
Gabriel P. Kuperminc, Ph.D
Professor of Psychology
Georgia State University
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Annette Verster, WHO
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
Performance-based financing presentation to the Health Financing AcceleratorReBUILD for Resilience
1) The document reviews evidence on the effectiveness of performance-based financing (PBF) and direct facility financing (DFF) approaches.
2) The Cochrane review found that PBF generally improved utilization and quality of targeted health services, but results were mixed for non-targeted indicators. Impacts on health outcomes were also mixed.
3) Evidence on DFF was limited but other reviews found prospective payment mechanisms like capitation can reduce costs while maintaining service utilization and quality of care.
Indian j communitymed463550-2090863_054828DRTEJASWINIHK
This study explored the prevalence of anemia and poor menstrual hygiene management (MHM) practices among 393 adolescent girls in an urban slum in Bhopal, India. The study found that 38.7% of participants were anemic, with 65.1% having mild anemia. Poor MHM practices, defined as unsatisfactory in 5 or more of 6 assessed parameters, were found in 87.3% of participants. Logistic regression analysis revealed significant associations between anemia and poor MHM practices, excessive menstrual bleeding, religion, education level, and nutritional status. The study concluded that concerted efforts are needed to improve awareness of MHM and access to sanitary facilities to help reduce the burden of anemia.
The Sehatmandi project is a 3-year health services delivery project running from 2018 to 2022 with a total budget of $622 million financed mainly by the World Bank, EU, USAID, and Canada. It is implemented through contracts with national and international NGOs in 31 provinces, with a strengthened mechanism in 3 provinces. Performance is managed by a Project Management Office, with contract management by a Grants and Contracts Management Unit and coordination through a Sehatmandi coordination office in the Ministry of Public Health. Key performance is tracked through over 200 indicators and reviewed at quarterly and annual meetings. Oversight is provided by a Health Sector Oversight Committee comprised of representatives from the Afghan government and international
Assessing the impact on child nutrition of Ethiopia’s Community-based Nutriti...essp2
The document summarizes an evaluation of Ethiopia's Community-based Nutrition (CBN) program conducted by Tulane University. The CBN program was implemented in rural areas through volunteer community health workers and health extension workers to monitor child growth, hold community conversations, and conduct home visits. The evaluation found the CBN program was associated with reductions in stunting and severe stunting compared to expected trends. Children in areas with more contact from health workers through the CBN program saw greater improvements in nutrition indicators. However, overall participation levels in the CBN program were low at 30%, suggesting increased community engagement is needed as the program expands its coverage across Ethiopia.
The document discusses Afghanistan's experience monitoring basic health services contracts with NGOs in a conflict setting. It outlines Afghanistan's complex monitoring and evaluation (M&E) system involving multiple departments and organizations. Resources for M&E activities are substantial, with a third party responsible for most activities at a cost of $3.2 million per year. The relationship between contract managers and service-providing NGOs aims to improve performance through monitoring reports and meetings, though external factors sometimes interfere.
Implementation of bphsphc afghanistan experience august 2019Najibullah Safi
The document discusses Afghanistan's experience implementing the Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS) through contracting non-governmental organizations (NGOs) since 2003. Key points include:
1) NGOs deliver health services in 31 of 34 provinces through competitive bidding managed by the Ministry of Public Health. Services are financed through international donors.
2) The BPHS defines 7 elements of primary health care including maternal and newborn care, child health and immunization, public nutrition, communicable disease treatment and control, mental health, disability and rehabilitation, and essential drug supply.
3) Health indicators like immunization rates and access to maternal health
Investments in tuberculosis control programs in Andhra Pradesh, such as engaging private healthcare providers and active case finding in urban slums, could provide substantial health benefits and reduce transmission at relatively low costs. Modeling studies estimate that private sector engagement could yield over 51,000 crore INR in benefits with a cost of 460 crore INR, resulting in a benefit-cost ratio of over 112. Adding active case finding in urban slums could increase benefits to over 84,000 crore INR at a cost of 826 crore INR, with a benefit-cost ratio above 101. While limitations exist, expanded tuberculosis control efforts in Andhra Pradesh show potential to cost-effectively reduce disease burden.
Covid 19 continuation of essential health servicesNajibullah Safi
This document discusses strategies for sustaining non-COVID-19 essential health services in Afghanistan during the COVID-19 pandemic. It notes that health service utilization has decreased and some providers have been affected by COVID-19. WHO recommended 10 strategic actions including prioritizing essential services, optimizing service delivery, maintaining health workforce and supplies, and strengthening communication and monitoring. Afghanistan established coordination committees and continued providing basic health services while adapting delivery and establishing separate fever clinics. Monitoring was increased and digital platforms expanded to support essential service delivery during the pandemic. The impact on services was mixed but the response provided opportunities to strengthen capacity.
Maternal Mortality Estimates, Methods and ProcessesPAHO_RHO
This document discusses maternal mortality estimation methods used by the UN Maternal Mortality Interagency Group and issues with the consultation process. It describes how countries are categorized based on available data and how estimates are calculated for each group. Concerns raised include the inclusion of late maternal deaths, use of constant correction factors over time, and lack of transparency in methods. The document also reviews maternal mortality data reported by countries to PAHO and compares estimates from different sources.
Impact and cost effectivene of rotavirus vaccine introduction in afghanistanNajibullah Safi
This document provides a summary of a cost-effectiveness analysis of introducing rotavirus vaccination in Afghanistan. The analysis finds that vaccination would be highly cost-effective compared to no vaccination. It estimates that over 10 years, vaccination could avert over 1 million cases, 661,000 outpatient visits, 49,000 hospitalizations and nearly 12,000 deaths. The incremental cost per disability-adjusted life year averted is estimated to be $103-$59 depending on perspective, below Afghanistan's GDP per capita threshold for cost-effectiveness. Sensitivity analysis showed results were robust to varying parameters like disease burden and vaccine price. The document discusses limitations and next steps to support government adoption of vaccination.
This case study examines the costs of dementia in China from 1990 to 2030. It finds that the total annual costs of dementia in China increased from $0.9 billion in 1990 to $47.2 billion in 2010 and are predicted to reach $69.0 billion in 2020 and $114.2 billion in 2030. The costs were categorized as direct medical costs, direct non-medical costs, and indirect costs. Informal care accounted for over 90% of costs in 1990 and 2000. Population aging and increasing dementia prevalence are major drivers of rising costs, especially from 2010 to 2020. To reduce future costs, China needs an integrated health and social care system and prevention strategies.
Najibullah Safi, MD, MSc. HPM presented on the history and current state of Afghanistan's health care system. He discussed key progress made in health indicators like immunization coverage and under-five mortality. However, challenges remain such as high stunting rates, poor quality of care in hospitals, and a high maternal mortality ratio. Moving forward, Afghanistan aims to implement an Integrated Package of Essential Health Services to address the triple burden of diseases. Principles of the way forward include prioritizing the poor, increasing community engagement, and raising domestic financing for health.
The document describes India's Revised National Tuberculosis Control Programme (RNTCP) which was implemented in 1993 to address weaknesses in the previous NTP program since 1962 such as managerial issues, inadequate funding, overreliance on x-rays for diagnosis, and supply issues. The RNTCP uses the DOTS strategy which focuses on political commitment, quality-assured sputum smear microscopy for diagnosis, adequate supply of quality-assured drugs, directly observed treatment, and systematic monitoring in order to achieve at least 85% cure rates for infectious TB cases and detect at least 70% of estimated cases. The RNTCP is organized with State TB Offices, Demonstration Centers, District Centers, and microscopy and treatment centers
Minnesota’s accountable communities for health soder145
The document summarizes Minnesota's Accountable Communities for Health (ACH) grant program and lessons from its first year. It provides context on the federal State Innovation Model initiative and Minnesota's Accountable Health Model. It then describes the ACH program, which funds 15 community collaboratives to coordinate care and implement prevention strategies. It outlines ACH experiences and highlights data sources for the state's multi-year evaluation, including interviews that identified accomplishments, barriers, and lessons learned from grantees in the program's first year.
The document provides an agenda and information about an upcoming Meaningful Use Mini-Camp on October 21, 2015. The agenda includes introductions, an overview of the California Technical Assistance Program (CTAP), a review of the 2015-2017 Modification Final Rule, a discussion of challenging measures, and strategic planning for Meaningful Use. Additional details are then provided about CTAP funding, milestones, and payments. The document concludes with sections on enrollment in CTAP and an overview of some of the most challenging Meaningful Use measures.
The document summarizes the experience of scaling up HIV treatment in Cameroon through operational research. Cameroon implemented a public health approach to decentralize HIV treatment from central and regional hospitals to district hospitals between 2001-2005. This was supported by standardized treatment guidelines, subsidies for laboratory tests, and a mentorship strategy. Operational research evaluated the impact and found early outcomes were better at district levels, including improved access, quality of care, adherence, and patient perceptions of decentralization. However, challenges remain around sustained drug supply, prevention of unsafe sex, and health worker satisfaction.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: John F. Ryan, Director, European Commission, DG SANTE
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
Impact of voucher system on access to maternal and child health services in E...Jeff Knezovich
John Bua of Makerere University presents on a voucher scheme in Eastern Uganda to transport pregnant women to the care facility at iHEA 2011 in Toronto, Canada.
Georgia Basics: Evaluation Results from Five Years of Intervention for Risky Drinking and Substance Use in Urban Emergency Departments
Presented by:
Gabriel P. Kuperminc, Ph.D
Professor of Psychology
Georgia State University
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Annette Verster, WHO
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
Performance-based financing presentation to the Health Financing AcceleratorReBUILD for Resilience
1) The document reviews evidence on the effectiveness of performance-based financing (PBF) and direct facility financing (DFF) approaches.
2) The Cochrane review found that PBF generally improved utilization and quality of targeted health services, but results were mixed for non-targeted indicators. Impacts on health outcomes were also mixed.
3) Evidence on DFF was limited but other reviews found prospective payment mechanisms like capitation can reduce costs while maintaining service utilization and quality of care.
Indian j communitymed463550-2090863_054828DRTEJASWINIHK
This study explored the prevalence of anemia and poor menstrual hygiene management (MHM) practices among 393 adolescent girls in an urban slum in Bhopal, India. The study found that 38.7% of participants were anemic, with 65.1% having mild anemia. Poor MHM practices, defined as unsatisfactory in 5 or more of 6 assessed parameters, were found in 87.3% of participants. Logistic regression analysis revealed significant associations between anemia and poor MHM practices, excessive menstrual bleeding, religion, education level, and nutritional status. The study concluded that concerted efforts are needed to improve awareness of MHM and access to sanitary facilities to help reduce the burden of anemia.
The Sehatmandi project is a 3-year health services delivery project running from 2018 to 2022 with a total budget of $622 million financed mainly by the World Bank, EU, USAID, and Canada. It is implemented through contracts with national and international NGOs in 31 provinces, with a strengthened mechanism in 3 provinces. Performance is managed by a Project Management Office, with contract management by a Grants and Contracts Management Unit and coordination through a Sehatmandi coordination office in the Ministry of Public Health. Key performance is tracked through over 200 indicators and reviewed at quarterly and annual meetings. Oversight is provided by a Health Sector Oversight Committee comprised of representatives from the Afghan government and international
Assessing the impact on child nutrition of Ethiopia’s Community-based Nutriti...essp2
The document summarizes an evaluation of Ethiopia's Community-based Nutrition (CBN) program conducted by Tulane University. The CBN program was implemented in rural areas through volunteer community health workers and health extension workers to monitor child growth, hold community conversations, and conduct home visits. The evaluation found the CBN program was associated with reductions in stunting and severe stunting compared to expected trends. Children in areas with more contact from health workers through the CBN program saw greater improvements in nutrition indicators. However, overall participation levels in the CBN program were low at 30%, suggesting increased community engagement is needed as the program expands its coverage across Ethiopia.
Assessing the impact on child nutrition of Ethiopia’s Community-based Nutriti...TogetherForNutrition
The document summarizes an evaluation of Ethiopia's Community-based Nutrition (CBN) program conducted by Tulane University. The CBN program was implemented in rural areas through volunteer community health workers and health extension workers to monitor child growth, hold community conversations, and conduct home visits. The evaluation found the CBN program was associated with reductions in stunting and severe stunting compared to expected trends. Children in areas with more contact from health workers through the CBN program saw greater improvements in nutrition indicators. However, overall participation levels in the CBN program were low at 30%, suggesting increased community engagement is needed as the program expands its coverage.
Evaluation of the Impact of a Social Support Strategy on Treatment OutcomesMEASURE Evaluation
Shared at a data dissemination and data use workshop on the results of the impact evaluation of the Strengthening Tuberculosis Control in Ukraine project. Access another presentation at https://www.slideshare.net/measureevaluation/evaluation-of-the-tbhiv-integration-strategy-on-treatment-outcomes.
- The document proposes a 3-tier healthcare system to improve primary healthcare in rural India. It involves dividing rural populations into communities of 500 people each, with 4-5 volunteers from each community providing basic healthcare. Volunteers undergo training and are supported by physical repositories stocked with medicines. The system aims to increase access, spread awareness, and utilize community networks and existing resources to improve rural health outcomes. Record keeping via health informatics will help evaluate the system's impact.
1) India has a high burden of tuberculosis, accounting for nearly 1/4 of global TB cases. The social and economic costs of TB in India are also high, with estimated indirect costs of $3 billion and direct costs of $300 million annually.
2) The National Tuberculosis Program (NTP) was implemented in 1962 but had low treatment success rates of only 30%. The Revised National Tuberculosis Control Program (RNTCP) was launched in 1993 using the WHO-recommended DOTS strategy.
3) RNTCP has expanded coverage to the entire country and achieved targets of 70% case detection and 85% treatment success rates. It has contributed to reducing prevalence and mortality rates of TB in India
The Field Health Service Information System (FHSIS) is a network that monitors health service delivery nationwide. It provides summary data on health services and program accomplishments at various government levels. The FHSIS aims to help local governments determine health priorities, monitor program implementation, and support planning, budgeting, and decision-making. It has several components, including the Individual Treatment Record, Target Client Lists, Summary Table, and Monthly Consolidation Table. Data is reported monthly, quarterly, and annually through various forms to track key health indicators.
Understanding the causal pathways within health systems policy evaluation thr...resyst
The document discusses using mediation analysis to understand the causal pathways through which a payment for performance (P4P) program in Tanzania influenced health outcomes. It finds the P4P program significantly improved several financing, governance, and human resources factors that could mediate its effects. Specifically, reduced stock-outs of oxytocin injections mediated 22% of the increased institutional deliveries and 30% of the increased deliveries at public facilities. Improved supervision frequency mediated 15% of the increased uptake of antimalarial doses during pregnancy. While illustrating indirect effects, mediation analysis relies on assumptions that are difficult to fully test and may oversimplify causal chains. The analysis provides insights but also reflections on further developing mediation methods for quasi
Zimbabwe: Results-Based Financing Improves Coverage, Quality and Financial Pr...RBFHealth
A presentation by Dr. Gwinji, Permanent Secretary, Ministry of Health, Zimbabwe and Dr. Tafadzwa Goverwa- Sibanda, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014. This event was hosted by the Health Results Innovation Trust Fund at The World Bank, in partnership with the PBF Community of Practice in Africa.
This document summarizes a proposed prospective study to rigorously evaluate the implementation of an expanded surgical care model (IMEESC-plus) at a district hospital in rural Nepal. The study aims to 1) evaluate the implementation process using mixed quantitative and qualitative methods at the hospital, staff, and patient levels, 2) pilot an implementation research methodology for potential larger studies, and 3) generate data to inform wider scale-up of surgical care globally. Specific objectives include evaluating hospital operations and costs, staff adherence to protocols and experiences, and changes in surgical volumes, complications, and patient follow-up over time.
State of Michigan HIE Update (without Tina Scott)mihinpr
This document summarizes health information technology (HIT) and health information exchange (HIE) efforts in the state of Michigan. It discusses the state's strategic priorities around improving population health, care delivery systems, and health care reform through initiatives like the State Innovation Model. It provides an overview of HIT programs and incentives like the Medicaid EHR Incentive Program. Key organizations involved include the Health Information Technology Commission and stakeholders working to advance HIT and HIE. The goal is to use health data and technology to improve care, outcomes and costs.
This document proposes solutions to improve universal access to quality primary healthcare in India. It discusses establishing a mobile healthcare delivery system using customized vans staffed with doctors and nurses that visit villages on a set schedule. It also proposes expanding medical insurance coverage to the poor and marginalized. Community engagement programs would train local healthcare workers and spread awareness. Transparency measures like a public health information system and grievance redressal are recommended to build confidence. Key indicators like maternal mortality rate and infant mortality rate would be monitored to assess the program's effectiveness. The total estimated annual cost is Rs. 10,665 crore with additional costs for community engagement programs and a health information system.
The Kingdom of Bhutan has made great achievement in establishing and sustaining public financed and managed health system in the past five and a half decades. As enshrined in the Constitution, health services are free in the integrated traditional and allopathic medicines. The report also notes the epidemiological and health system challenges and the way forward to overcome in line with achieving SDGs.
Evaluation of the Rwanda Community Performance-Based Financing ProgramRBFHealth
This study evaluates the impact of two interventions introduced as part of the Rwanda Community Performance-Based Financing Program to increase coverage of targeted maternal and child health services: rewards to cooperatives of community health workers and demand-side conditional in-kind transfers. The evaluation exploits experimental design with intervention randomly assigned at the sub-district level for a duration of two and a half years. The analysis finds no impact of the incentives to cooperatives of community health workers. However, conditional in-kind demand-side incentives are shown to significantly increase take up of timely antenatal and postnatal consultations.
Nepal Health Sector Program Implementation Plan II (NHSP-IP2)Dip Narayan Thakur
The document summarizes Nepal's Health Sector Implementation Plan II (NHSP-IP II). NHSP-IP II aimed to strengthen Nepal's health system from 2010-2015 by improving access, equity, and utilization of essential health services. It reviewed achievements and shortcomings of NHSP-IP I and outlined NHSP-IP II's vision, goals, strategies, and financing plans. Key points included reducing morbidity and mortality through accessible, affordable, quality care; addressing sustainability issues in health financing; and achieving greater efficiency through health systems strengthening. Progress was made in areas like immunization and maternal health, but challenges remained around nutrition, non-communicable diseases, and equity gaps.
Similar to Annual Results and Impact Evaluation Workshop for RBF - Day Eight - Impact Evaluation Note - Lesotho (20)
Setting a Path for Improved Health Outcomes RBFRBFHealth
Learning is a critical part of the HRITF RBF portfolio, with all programs benefiting from an embedded impact evaluation and in some cases, complemented by qualitative research components such as process evaluation studies. The presentation discusses the following topics:
1. Using RBF at the community-level to address demand side barriers
This presentation elaborates on the early evidence and the rationale for using RBF at the community level. It will share lessons learned from the implementation of community RBF at country level.
2. Using RBF to Strengthen Quality of Care: Early Lessons
This presentation discusses the broader policy implications of using RBF to strengthen the quality of care. It will explore how Measuring and Paying for the Quality of Care has been operationalized and will highlight the experience of Nigeria. Lastly, it will focus on measuring and Analyzing the Quality of Care from the Impact Evaluation perspective.
Cost-Effectiveness Analysis of RBF in Zimbabwe and ZambiaRBFHealth
Profs. Shepard and Zeng have been leading projects for the Bank to develop methods for performing a cost-effectiveness analysis of Results-Based Financing (RBF) programs and applying them to maternal-child health (MCH) services in Zambia and Zimbabwe. Both countries’ RBF programs proved highly cost-effective. Methods and results should be informative to other RBF and MCH programs.
RBF districts saw increases in some key health indicators compared to control districts, including institutional deliveries and the timing of first antenatal care visits. Quality of services improved in some areas for RBF districts such as structural quality indices and availability of some delivery equipment. Health systems were strengthened under RBF, with increases in facility governance, autonomy, and job satisfaction reported compared to control districts. The results provide evidence that RBF had a positive impact on priority health services in Zambia.
Performance-based financing of maternal and child health: non-experimental ev...RBFHealth
Ellen Van de Poel presents the findings of two studies that evaluate the impact of Performance-Based Financing (PBF) in Burundi and Cambodia. Both studies exploit the geographic expansion of PBF to estimate its effect on the utilization of maternal and child health services using data from the Demographic Health Surveys.
Success beyond numbers: The Salud Mesoamerica Initiative’s results-based fin...RBFHealth
The Salud Mesoamérica Initiative (SMI) is a public-private partnership between the Bill & Melinda Gates Foundation (BMGF), the Carlos Slim Foundation, the Government of Spain, the Inter-American Development Bank (IDB), the countries of Central America and the State of Chiapas in Mexico. SMI works to reduce maternal and health inequalities through a results-based financing model, aligned with priorities established by the governments of the region. Among the poor in Mesoamerica, only 5 out of every 10 pregnant women are attended during childbirth by skilled birth personnel and the mortality rate among children in poverty is twice that of the national average.
Building agile and data-driven health system is a fundamental component of the Universal Health Coverage agenda. Data-driven health systems will require that countries set up smart data systems coupled with dynamic and reactive health financing instruments.
A large number of the low-income countries enhance their strategic purchasing function with the introduction of Results-Based Financing (RBF) instruments. In this presentation, Nicolas de Borman describes how the combination of DHIS2 platforms, RBF and mobile devices help build strategic purchasing function in health systems.
Sumar Program's Universal Coverage: Achievements & New Goals Towards 2020RBFHealth
A presentation by Martín Sabignoso of Argentina's Ministry of Health delivered at the RBF Health Seminar, QOn the Road to Effective Universal Health Coverage: What’s New in Argentina’s Use of Performance Incentives? on June 11, 2015.
Long run effects of temporary incentives on medical care productivity in Arge...RBFHealth
A presentation by Pablo Celhay, Paul Gertler, Paula Giovagnoli and Christel Vermeersch, delivered at the RBF Health Seminar, On the Road to Effective Universal Health Coverage: What’s New in Argentina’s Use of Performance Incentives? on June 11, 2015.
Qualitative Research in Results-Based Financing: The Promise and The RealityRBFHealth
This document summarizes a review of qualitative research conducted as part of results-based financing (RBF) studies. The review assessed 17 RBF studies and found that while qualitative research holds promise to understand complex health systems, several challenges exist in practice. Studies often lacked depth in contextualization, sampling, and data collection methods. Opportunities exist to strengthen qualitative RBF research through more formative work to inform study design, locally grounded conceptual frameworks, strengthened fieldwork practices, and smaller, more focused qualitative components.
Effect of Voucher Programs on Utilization, Out-of-Pocket Expenditure and Qual...RBFHealth
A presentation by Timothy Abuya, delivered at the RBF Health Seminar, The Role of Vouchers in Serving Disadvantaged Populations and Improving Quality of Care.
A presentation by Ben Bellows, delivered at the RBF Health Seminar, The Role of Vouchers in Serving Disadvantaged Populations and Improving Quality of Care.
WHO Implementation Research Program on Factors Explaining Success and Failure...RBFHealth
This document discusses implementation research on scaling up Results-Based Financing (RBF) programs from pilot schemes to integrated national health systems. It calls for case studies on RBF initiatives in select low and middle-income countries to identify factors that enable or hinder this transition. Selected proposals will examine RBF scale-up experiences in multiple countries. Next steps include a protocol development workshop to design the research and analyze findings to draw cross-cutting lessons on scaling up RBF.
The Science of Delivery: Use of Administrative Data in The HRITF PortfolioRBFHealth
A presentation by Ha Thi Hong Nguyen, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014. This event was hosted by the Health Results Innovation Trust Fund at The World Bank, in partnership with the PBF Community of Practice in Africa.
PBF Conceptual Framework and Illustration with The Case of NigeriaRBFHealth
A presentation by Dinesh Nair, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014. This event was hosted by the Health Results Innovation Trust Fund at The World Bank, in partnership with the PBF Community of Practice in Africa.
India - Karnataka: An Experimental Evaluation of Government Health Insurance ...RBFHealth
A presentation by Somil Nagpal, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014. This event was hosted by the Health Results Innovation Trust Fund at The World Bank, in partnership with the PBF Community of Practice in Africa.
What Are Results-Based Financing Programs Doing Around The World, State of Th...RBFHealth
A presentation by Dinesh Nair, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014. This event was hosted by the Health Results Innovation Trust Fund at The World Bank, in partnership with the PBF Community of Practice in Africa.
A presentation by Bruno Meessen, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014.
Providing Health in Difficult Contexts: Pre-Pilot Performance-Based Financing...RBFHealth
The Adamawa Primary Health Care System in Nigeria has implemented performance-based financing (PBF) to address underlying issues plaguing the health system. After two years of pre-pilot implementation, results have been encouraging with improvements in key indicators like institutional deliveries and vaccination rates. Success stories like Mayo-Ine health center demonstrate how community engagement and strengthened management can boost coverage. However, some indicators still show room for growth, and deeper analysis finds issues like staffing shortages and infrastructure problems influencing performance. Moving forward, continued scale-up and addressing broader health system challenges will be important to sustain gains under PBF in Adamawa State.
Innovations in Results-Based Financing in the Latin America and Caribbean RegionRBFHealth
Presentations delivered during "Innovations in Results-Based Financing in the Latin America and Caribbean Region" seminar at the World Bank on May 22, 2014.
These slides feature a comparative review of different types of results-based financing schemes in the Latin America and Caribbean region, as well as case studies from selected schemes.
nursing management of patient with Empyema pptblessyjannu21
prepared by Prof. BLESSY THOMAS, SPN
Empyema is a disease of respiratory system It is defines as the accumulation of thick, purulent fluid within the pleural space, often with fibrin development.
Empyema is also called pyothorax or purulent pleuritis.
It’s a condition in which pus gathers in the area between the lungs and the inner surface of the chest wall. This area is known as the pleural space.
Pus is a fluid that’s filled with immune cells, dead cells, and bacteria.
Pus in the pleural space can’t be coughed out. Instead, it needs to be drained by a needle or surgery.
Empyema usually develops after pneumonia, which is an infection of the lung tissue. it is mainly caused due in infectious micro-organisms. It can be treated with medications and other measures.
Solution manual for managerial accounting 18th edition by ray garrison eric n...rightmanforbloodline
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
The Importance of Black Women Understanding the Chemicals in Their Personal C...bkling
Certain chemicals, such as phthalates and parabens, can disrupt the body's hormones and have significant effects on health. According to data, hormone-related health issues such as uterine fibroids, infertility, early puberty and more aggressive forms of breast and endometrial cancers disproportionately affect Black women. Our guest speaker, Jasmine A. McDonald, PhD, an Assistant Professor in the Department of Epidemiology at Columbia University in New York City, discusses the scientific reasons why Black women should pay attention to specific chemicals in their personal care products, like hair care, and ways to minimize their exposure.
Mental Health and well-being Presentation. Exploring innovative approaches and strategies for enhancing mental well-being. Discover cutting-edge research, effective strategies, and practical methods for fostering mental well-being.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
Emotional and Behavioural Problems in Children - Counselling and Family Thera...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Research, Monitoring and Evaluation, in Public Healthaghedogodday
This is a presentation on the overview of the role of monitoring and evaluation in public health. It describes the various components and how a robust M&E system can possitively impact the results or effectiveness of a public health intervention.
Sectional dentures for microstomia patients.pptxSatvikaPrasad
Microstomia, characterized by an abnormally small oral aperture, presents significant challenges in prosthodontic treatment, including limited access for examination, difficulties in impression making, and challenges with prosthesis insertion and removal. To manage these issues, customized impression techniques using sectional trays and elastomeric materials are employed. Prostheses may be designed in segments or with flexible materials to facilitate handling. Minimally invasive procedures and the use of digital technologies can enhance patient comfort. Education and training for patients on prosthesis care and maintenance are crucial for compliance. Regular follow-up and a multidisciplinary approach, involving collaboration with other specialists, ensure comprehensive care and improved quality of life for microstomia patients.
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...DrDevTaneja1
Digital India will need a big trained army of Health Informatics educated & trained manpower in India.
Presently, generalist IT manpower does most of the work in the healthcare industry in India. Academic Health Informatics education is not readily available at school & health university level or IT education institutions in India.
We look into the evolution of health informatics and its applications in the healthcare industry.
HIMMS TIGER resources are available to assist Health Informatics education.
Indian Health universities, IT Education institutions, and the healthcare industry must proactively collaborate to start health informatics courses on a big scale. An advocacy push from various stakeholders is also needed for this goal.
Health informatics has huge employment potential and provides a big business opportunity for the healthcare industry. A big pool of trained health informatics manpower can lead to product & service innovations on a global scale in India.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
As Mumbai's premier kidney transplant and donation center, L H Hiranandani Hospital Powai is not just a medical facility; it's a beacon of hope where cutting-edge science meets compassionate care, transforming lives and redefining the standards of kidney health in India.
CHAPTER 1 SEMESTER V COMMUNICATION TECHNIQUES FOR CHILDREN.pdfSachin Sharma
Here are some key objectives of communication with children:
Build Trust and Security:
Establish a safe and supportive environment where children feel comfortable expressing themselves.
Encourage Expression:
Enable children to articulate their thoughts, feelings, and experiences.
Promote Emotional Understanding:
Help children identify and understand their own emotions and the emotions of others.
Enhance Listening Skills:
Develop children’s ability to listen attentively and respond appropriately.
Foster Positive Relationships:
Strengthen the bond between children and caregivers, peers, and other adults.
Support Learning and Development:
Aid cognitive and language development through engaging and meaningful conversations.
Teach Social Skills:
Encourage polite, respectful, and empathetic interactions with others.
Resolve Conflicts:
Provide tools and guidance for children to handle disagreements constructively.
Encourage Independence:
Support children in making decisions and solving problems on their own.
Provide Reassurance and Comfort:
Offer comfort and understanding during times of distress or uncertainty.
Reinforce Positive Behavior:
Acknowledge and encourage positive actions and behaviors.
Guide and Educate:
Offer clear instructions and explanations to help children understand expectations and learn new concepts.
By focusing on these objectives, communication with children can be both effective and nurturing, supporting their overall growth and well-being.
2. Background
• Small landlocked country, 1.9m
• Mountainous terrain
• High maternal (1,155/100,000 births) and under-five
mortality (86/1,000 births)
• 3rd highest HIV prevalence (23.2%)
• Two main service providers (Public and CHAL)
• 10 districts (capital district excluded from PBF)
2
3. Description of Intervention
• Improving MNH services via incentive payments
o Health centers together with VHWs (quantity, quality and
remoteness)
o District hospitals (quantity, and quality)
o DHMTs for supervision
• 3 phases
o Phase 1 ( 2 districts, not part of impact evaluation)
o Phase 2 (additional 4 districts, 1 year after Phase 1)
o Phase 3 (additional 3 districts, 2 years after phase 1)
3
4. Primary Research Questions
• What is the causal effect of the PBF program on
o quantity of MNH services
o quality of MNH services
o health outcomes ?
• What is the cost-effectiveness of PBF vs. additional health
financing not tied to performance?
• Does the PBF program reduce inequity?
4
5. Outcome Indicators
• % institutional deliveries
• % fully immunized
• % women using modern contraceptives
• Quality of care score
• Weight-for-age, height-for-age
• Prevalence of anemia
5
6. Randomized phase-in design
Full PBF package:
Linking payments and
results
Managerial autonomy
within defined limits
Systematic supervision
Additional Resources:
Not tied to performance
Equaling average
resources of treatment
Follow existing guidelines
about use of funds
Switch to PBF when study
ends!
Treatment Control
Health centers will be randomized into 2 study groups:
7. Sample
Households with women
of childbearing age
Health
Centers
Study Arms
PBF IE
Treatment
1 2 … 44
1 2 …
…
25
0
Control
1 2 … 44
Total: 88 health centers, up to 2,200 households
8. Data: Household Surveys
Sample:
• Households in catchment areas served by the control and
treatment facilities
• The selected household will have a woman with a recent
pregnancy
Survey components:
• Household roster and socioeconomic status
• Utilization and health behaviors regarding MNH services
• Household health expenditure
• Perceptions of health service quality
• Anthropometry and biomarker: and anemia
9. Timeline
Phase
2
districts
Phase
3
districts
Treatment
Control
Treatment
Control
Implementa)on
Survey
Implementa)on
Survey
Implementa)on
Survey
Implementa)on
Survey
2015
Q1
Baseline
Baseline
Q2
Q3
Full
PBF
Addi;onal
Financing
Q4
2016
Q1
Baseline
Baseline
Q2
Q3
Full
PBF
Addi;onal
Financing
Q4
2017
Q2
Q3
Q4
Q1
2017
Q2
Endline
Endline
Q3
Endline
Endline
Q3
Full
PBF
Full
PBF
Q4