The 2nd NHSC meeting was held on December 29, 2011 to update members on GAVI HSS activities over the past 3 months, seek endorsement of the GAVI HSS work plan for the next 3 months, and present Coordinated Township Health Plans (CTHPs) for the first 20 townships. The meeting included presentations on GAVI HSS expenditures, activities conducted, findings from health system assessments, and the CTHPs. Members provided feedback and recommendations to strengthen health system components like human resources and financing. The work plan and CTHPs were endorsed for implementation with an emphasis on sustainability and expanding management roles over time.
The document describes a health systems strengthening framework for Myanmar that aims to address gaps in service delivery, program coordination, and human resources. It identifies key health system areas needing improvement, including increasing access to essential maternal and child health services in hard to reach areas, strengthening coordination across health programs, and improving the distribution and skills of health workers. The framework outlines objectives, activities, indicators and timelines to guide investments in infrastructure, supplies, transport, training, research and incentives over four years across 180 townships, with the goal of reducing child mortality and increasing access to primary healthcare services.
This document provides a public expenditure review of the Kenyan Ministry of Health for 2007. It outlines the overall and specific objectives of the review, which include presenting government health policies and programs, examining public health expenditure distributions, and assessing budget effectiveness and constraints. Key findings are that communicable diseases remain prevalent, but fertility and population growth rates are declining. The multi-tiered health system has issues with capacity, financing, accessibility, and centralized allocation of funds. The National Health Sector Strategic Plan is aligned with the country's Economic Recovery Strategy to improve financing, target the poor, increase cross-sector cooperation and efficiency, and boost government health funding.
HSFR/HFG End of Project Regional Report - TigrayHFG Project
The document summarizes health care financing reforms supported by the USAID-funded HSFR/HFG project in the Tigray region of Ethiopia. Key achievements include:
1) Increasing the number of health facilities with functional governing boards and management committees to improve governance and use of retained revenue.
2) Doubling the amount of revenue retained and utilized by health facilities over three years through the revenue retention and utilization reform.
3) Expanding community-based health insurance (CBHI) to cover 69% of woredas and over 1 million beneficiaries, increasing resources mobilized through the program to over 141 million birr.
The document summarizes an interview with the Chief of Party/Project Director of the HSFR/HFG Project in Ethiopia.
In the past fiscal year, the project focused on consolidating first generation health care financing reforms and preparing for universal health coverage through activities like building implementation capacity and expanding community-based health insurance. The project performed well, with achievements like graduating supported health facilities, expanding CBHI to more areas, and conducting evaluations.
Looking ahead, the project will focus on further expanding CBHI, launching social health insurance, strengthening supported health facilities, and generating health financing evidence to support policymaking. The Chief of Party expressed gratitude for partnerships while noting ongoing challenges like staff turnover and expanding initiatives to new areas
Health newsletter 5 - Enabel and Ministry of Health of UgandaHannes De Meyer
The newsletter provides updates on various health projects in Uganda, including the Institutional Capacity Building project, Private Not-for-Profit project, and the introduction of results-based financing. It discusses the donation of 41 motorcycles to health facilities implementing results-based financing to help with transportation issues. It also covers the renaming of the Belgian development agency BTC to Enabel to better align with sustainable development goals.
Essential Package of Health Services Country Snapshot: MozambiqueHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Summary of Telemedicine study in Serbia / Sažetak studije o Telemedicini u Sr...NALED Serbia
Studija o potencijalima primene telemedicine u Srbiji i njenim benefitima za građane i lokalne samouprave.
Study on the potentials of implementation of telemedicine in Serbia and its benefits for the citizens and local governments.
The document describes a health systems strengthening framework for Myanmar that aims to address gaps in service delivery, program coordination, and human resources. It identifies key health system areas needing improvement, including increasing access to essential maternal and child health services in hard to reach areas, strengthening coordination across health programs, and improving the distribution and skills of health workers. The framework outlines objectives, activities, indicators and timelines to guide investments in infrastructure, supplies, transport, training, research and incentives over four years across 180 townships, with the goal of reducing child mortality and increasing access to primary healthcare services.
This document provides a public expenditure review of the Kenyan Ministry of Health for 2007. It outlines the overall and specific objectives of the review, which include presenting government health policies and programs, examining public health expenditure distributions, and assessing budget effectiveness and constraints. Key findings are that communicable diseases remain prevalent, but fertility and population growth rates are declining. The multi-tiered health system has issues with capacity, financing, accessibility, and centralized allocation of funds. The National Health Sector Strategic Plan is aligned with the country's Economic Recovery Strategy to improve financing, target the poor, increase cross-sector cooperation and efficiency, and boost government health funding.
HSFR/HFG End of Project Regional Report - TigrayHFG Project
The document summarizes health care financing reforms supported by the USAID-funded HSFR/HFG project in the Tigray region of Ethiopia. Key achievements include:
1) Increasing the number of health facilities with functional governing boards and management committees to improve governance and use of retained revenue.
2) Doubling the amount of revenue retained and utilized by health facilities over three years through the revenue retention and utilization reform.
3) Expanding community-based health insurance (CBHI) to cover 69% of woredas and over 1 million beneficiaries, increasing resources mobilized through the program to over 141 million birr.
The document summarizes an interview with the Chief of Party/Project Director of the HSFR/HFG Project in Ethiopia.
In the past fiscal year, the project focused on consolidating first generation health care financing reforms and preparing for universal health coverage through activities like building implementation capacity and expanding community-based health insurance. The project performed well, with achievements like graduating supported health facilities, expanding CBHI to more areas, and conducting evaluations.
Looking ahead, the project will focus on further expanding CBHI, launching social health insurance, strengthening supported health facilities, and generating health financing evidence to support policymaking. The Chief of Party expressed gratitude for partnerships while noting ongoing challenges like staff turnover and expanding initiatives to new areas
Health newsletter 5 - Enabel and Ministry of Health of UgandaHannes De Meyer
The newsletter provides updates on various health projects in Uganda, including the Institutional Capacity Building project, Private Not-for-Profit project, and the introduction of results-based financing. It discusses the donation of 41 motorcycles to health facilities implementing results-based financing to help with transportation issues. It also covers the renaming of the Belgian development agency BTC to Enabel to better align with sustainable development goals.
Essential Package of Health Services Country Snapshot: MozambiqueHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Summary of Telemedicine study in Serbia / Sažetak studije o Telemedicini u Sr...NALED Serbia
Studija o potencijalima primene telemedicine u Srbiji i njenim benefitima za građane i lokalne samouprave.
Study on the potentials of implementation of telemedicine in Serbia and its benefits for the citizens and local governments.
Olivier Basenya - PERFORMANCE BASED FINANCING in BURUNDIRikuE
This document outlines the implementation of performance-based financing (PBF) in Burundi's health sector. PBF was introduced to address issues like lack of health personnel and low quality of care. It was piloted in 2006-2007 across three provinces with support from NGOs. Initial results showed improved health indicators, quality of services, and motivation of health workers. The government now aims to scale up PBF nationwide by 2009 with support from partners like the World Bank and European Commission. Key future challenges include fully institutionalizing PBF and establishing independent funding agencies.
This document provides an overview of decentralizing health services in Malawi. It discusses progress made so far in decentralizing functions like finance, procurement, and service delivery to district levels. It identifies gaps in policies, laws, and implementation and makes recommendations. Key points include clarifying roles and responsibilities at each level, ensuring coordinated support from central, regional, and district structures, establishing city health directorates, building financial management capacity, and providing guidelines for partner involvement. The document also examines challenges in decentralizing human resources and the architecture for managing health workers in a decentralized system.
Uganda experience by Dr Tonny Tumwesigye, UPMBachapkenya
The document discusses Uganda's decentralization of healthcare, beginning in the 1990s. It transferred power over healthcare from the central government to local governments. This aimed to improve access, accountability, and responsiveness to local needs. Key reforms included establishing local councils and formally decentralizing political, administrative, and fiscal control through acts in 1993 and 1997. The reforms achieved some successes, like improved staff distribution and accountability. However, challenges remain regarding human resources, planning, funding imbalances, and local revenue management under the decentralized system.
The document summarizes USAID's efforts over 3 years to strengthen the organizational capacity of Burundi's National HIV/AIDS Program (PNLS). Through training, workshops, and technical assistance, PNLS improved in key areas like strategic planning, project management, coordination, and monitoring. This enabled PNLS to take on greater leadership of Burundi's HIV response, including becoming the principal recipient of Global Fund grants. The transformation of PNLS from a weak to effective organization illustrates the importance of building both technical and foundational management capacities.
This document outlines Colorado's process for establishing maternal and child health priorities and moving from identifying priorities to implementing action plans at both the state and local level. Key aspects included conducting a needs assessment to identify 7-10 priorities, forming implementation teams for each priority, developing logic models and action plans, providing training and support, and establishing accountability mechanisms. The process aimed to better align state and local efforts and promote a coordinated, evidence-based approach to improving MCH outcomes over five years. Feedback was incorporated to enhance communication, support, and timeline management for future priority setting cycles.
HFG Democratic Republic of Congo Final Country Report HFG Project
The USAID Health Finance and Governance project works to improve health systems in developing countries. Led by Abt Associates, the project helps countries increase domestic health funding, manage resources effectively, and make wise purchasing decisions. In the Democratic Republic of Congo, the project worked with the Ministry of Health to strengthen governance and management under a decentralization reform. Key accomplishments included establishing and building capacity of new provincial health divisions, developing human resources standards and guidelines, and institutional strengthening of central directorates to support the reform.
The document provides a health profile of Benue State, Nigeria. It summarizes key health indices like tuberculosis prevalence (13,000+ affected), HIV prevalence (15.4%), and stakeholders involved in health. It describes USAID/HFG project interventions in the state like budget advocacy, capacity building, and establishing a Resource Mobilization Technical Working Group. The project achieved a 62% increased budget allocation and release of previously withheld funds. Challenges included limited time and insecurity, while recommendations focused on ownership, capacity building and longer timelines.
Devolution of health services in Kenya by Dr Samuel Mwenda, CHAKachapkenya
This document discusses the devolution of health services in Kenya following the new constitution of 2010. It summarizes that health services are now managed at the county level while the national government focuses on policy, referral hospitals, and training. It outlines the challenges of transitioning to this new system, including establishing new governance structures and changing the employment of health workers. Faith-based organizations still play an important role in healthcare delivery and need to find ways to engage with each county government to ensure access to resources and their patients' needs are still met under the devolved system.
The document discusses health budgeting in India, with a focus on the National Rural Health Mission (NRHM). It provides an overview of health expenditures, the union budget for health, and the financial management structures and processes under NRHM at the central, state, district, block and lower levels. Planning and budgeting follows a bottom-up approach under NRHM, with plans developed at each administrative level that are then aggregated into State Program Implementation Plans for approval.
Repositioning the Health Economics UnitHFG Project
The document discusses a proposal to reposition the Health Economics Unit (HEU) within the Ministry of Health and Family Welfare in Bangladesh. The proposal aims to clarify and focus the HEU's mandate on supporting universal healthcare through health economics analysis and policy guidance. It recommends refocusing the HEU's activities, limiting its scope by relocating certain units, renaming it the Directorate General of Health Economics and Policy, and establishing four new technical units. It also addresses staffing limitations and the need to strengthen collaboration to effectively implement the proposed changes.
The document outlines ACHAP's strategic plan for 2015-2020. It begins with ACHAP's vision, mission,
and core values. It then analyzes the current situation, noting that faith-based organizations operate
30-70% of health facilities in Africa but often remain unrecognized. ACHAP was established in 2007
to advocate and build networks among Christian health associations. The strategic plan aims to
better equip ACHAP to advocate, negotiate contracts, support members, coordinate synergies, and
provide leadership over the next 5 years.
The document summarizes a stakeholder workshop on a Joint Strategic Needs Assessment (JSNA) for transport and health in Cambridgeshire. The workshop discussed what a JSNA is, background and aims of the transport and health JSNA, and key topics of access and health, active transport, and air pollution. Attendees provided input on local issues, initiatives, and solutions for each topic. Next steps outlined forming working groups to analyze data and produce the JSNA to inform local decision-making.
HSFR/HFG End of Project Regional Report - AmharaHFG Project
The document discusses health care financing reforms implemented in the Amhara region of Ethiopia with support from the USAID-funded HSFR/HFG project. The reforms aimed to improve access to and quality of health services. Key reforms included establishing governing boards at health facilities, allowing facilities to retain and utilize generated revenue, and recruiting financial management staff. As a result of these reforms, the number of facilities with governing boards increased from 776 to 891, and the number implementing revenue retention doubled from 2013 to 2018. Revenue retained also increased substantially over this period.
1) The document summarizes the findings of a rapid capacity appraisal conducted in Niger State, Nigeria to assess progress in malaria control capacity after 5 years of support from the Support to National Malaria Programme (SuNMaP).
2) It finds that while some improvements have been made in areas like monitoring and evaluation and program management, capacity remains weak, especially in areas like disease surveillance and regulation. In particular, most staff in the state malaria control program have low qualifications.
3) Key recommendations include increasing government funding for malaria control, strengthening data management systems, ensuring technical assistance builds state capacity, and supporting establishment of a drug management agency.
The USAID Health Finance and Governance project, led by Abt Associates, works with developing countries to expand access to healthcare. It helps countries increase domestic health funding, better manage those resources, and make wise purchasing decisions. The project has worked in Cote d'Ivoire since 2013 to address challenges in human resources, health financing, and governance that were preventing effective delivery of HIV and other health services. Key accomplishments include a six-fold increase in the number of health workers trained to provide HIV treatment through task-sharing policies and curriculum changes.
Kathy Kunkle is a Human Services Program Specialist Administrator for Ingenesis, Inc. in Harrisburg, PA. Her role involves developing policies and procedures for Pennsylvania's statewide Nursing Home Transition program. She collects and analyzes data to track program outcomes and ensures compliance with regulations. Kunkle has experience in case management, billing, and administration for human services programs. She previously worked in construction and retail management.
The USAID Health Finance and Governance project in Angola helped the Ministry of Health develop a costed National Health Plan and monitoring and evaluation system to better advocate for health funding. Specifically:
1) HFG assisted MINSA in calculating a 12-year $6.3 billion budget to implement the National Health Plan, which helped gain approval and political support for increased health funding.
2) An M&E plan was developed and led to the creation of an M&E department at MINSA to track health spending and sector progress.
3) Efforts were made to establish a health accounting system to measure how funds are actually spent, but this was not completed due to a change in government leadership.
Essential Package of Health Services Country Snapshot: ZambiaHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Essential Package of Health Services Country Snapshot: The Republic of South ...HFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
This document provides an overview of district health planning in India. It defines district health planning and explains its purpose to improve health services and match limited resources to needs. A brief history is given of decentralized planning starting in India's first five-year plan. Key components of district health planning are identified, including situation analysis, priority setting, annual facility plans, and developing a district health action plan. The planning process involves different committees at village, block and district levels. The document provides an example of strengthening routine immunization for migratory populations in Gurgaon district.
The document discusses gaps in Myanmar's health system that hinder progress on MDG goals related to child mortality. It identifies gaps in service delivery, program coordination, and human resources. The Health Systems Strengthening goal is to improve essential health services for mothers and children by strengthening coordination, planning, and human resources management. Key activities include expanding service access in remote areas, developing guidelines for coordinated township health plans, researching effective health financing schemes, and ensuring adequate staffing levels according to national standards. Outcomes will be measured by coverage indicators like DTP3 and skilled birth attendance rates.
Olivier Basenya - PERFORMANCE BASED FINANCING in BURUNDIRikuE
This document outlines the implementation of performance-based financing (PBF) in Burundi's health sector. PBF was introduced to address issues like lack of health personnel and low quality of care. It was piloted in 2006-2007 across three provinces with support from NGOs. Initial results showed improved health indicators, quality of services, and motivation of health workers. The government now aims to scale up PBF nationwide by 2009 with support from partners like the World Bank and European Commission. Key future challenges include fully institutionalizing PBF and establishing independent funding agencies.
This document provides an overview of decentralizing health services in Malawi. It discusses progress made so far in decentralizing functions like finance, procurement, and service delivery to district levels. It identifies gaps in policies, laws, and implementation and makes recommendations. Key points include clarifying roles and responsibilities at each level, ensuring coordinated support from central, regional, and district structures, establishing city health directorates, building financial management capacity, and providing guidelines for partner involvement. The document also examines challenges in decentralizing human resources and the architecture for managing health workers in a decentralized system.
Uganda experience by Dr Tonny Tumwesigye, UPMBachapkenya
The document discusses Uganda's decentralization of healthcare, beginning in the 1990s. It transferred power over healthcare from the central government to local governments. This aimed to improve access, accountability, and responsiveness to local needs. Key reforms included establishing local councils and formally decentralizing political, administrative, and fiscal control through acts in 1993 and 1997. The reforms achieved some successes, like improved staff distribution and accountability. However, challenges remain regarding human resources, planning, funding imbalances, and local revenue management under the decentralized system.
The document summarizes USAID's efforts over 3 years to strengthen the organizational capacity of Burundi's National HIV/AIDS Program (PNLS). Through training, workshops, and technical assistance, PNLS improved in key areas like strategic planning, project management, coordination, and monitoring. This enabled PNLS to take on greater leadership of Burundi's HIV response, including becoming the principal recipient of Global Fund grants. The transformation of PNLS from a weak to effective organization illustrates the importance of building both technical and foundational management capacities.
This document outlines Colorado's process for establishing maternal and child health priorities and moving from identifying priorities to implementing action plans at both the state and local level. Key aspects included conducting a needs assessment to identify 7-10 priorities, forming implementation teams for each priority, developing logic models and action plans, providing training and support, and establishing accountability mechanisms. The process aimed to better align state and local efforts and promote a coordinated, evidence-based approach to improving MCH outcomes over five years. Feedback was incorporated to enhance communication, support, and timeline management for future priority setting cycles.
HFG Democratic Republic of Congo Final Country Report HFG Project
The USAID Health Finance and Governance project works to improve health systems in developing countries. Led by Abt Associates, the project helps countries increase domestic health funding, manage resources effectively, and make wise purchasing decisions. In the Democratic Republic of Congo, the project worked with the Ministry of Health to strengthen governance and management under a decentralization reform. Key accomplishments included establishing and building capacity of new provincial health divisions, developing human resources standards and guidelines, and institutional strengthening of central directorates to support the reform.
The document provides a health profile of Benue State, Nigeria. It summarizes key health indices like tuberculosis prevalence (13,000+ affected), HIV prevalence (15.4%), and stakeholders involved in health. It describes USAID/HFG project interventions in the state like budget advocacy, capacity building, and establishing a Resource Mobilization Technical Working Group. The project achieved a 62% increased budget allocation and release of previously withheld funds. Challenges included limited time and insecurity, while recommendations focused on ownership, capacity building and longer timelines.
Devolution of health services in Kenya by Dr Samuel Mwenda, CHAKachapkenya
This document discusses the devolution of health services in Kenya following the new constitution of 2010. It summarizes that health services are now managed at the county level while the national government focuses on policy, referral hospitals, and training. It outlines the challenges of transitioning to this new system, including establishing new governance structures and changing the employment of health workers. Faith-based organizations still play an important role in healthcare delivery and need to find ways to engage with each county government to ensure access to resources and their patients' needs are still met under the devolved system.
The document discusses health budgeting in India, with a focus on the National Rural Health Mission (NRHM). It provides an overview of health expenditures, the union budget for health, and the financial management structures and processes under NRHM at the central, state, district, block and lower levels. Planning and budgeting follows a bottom-up approach under NRHM, with plans developed at each administrative level that are then aggregated into State Program Implementation Plans for approval.
Repositioning the Health Economics UnitHFG Project
The document discusses a proposal to reposition the Health Economics Unit (HEU) within the Ministry of Health and Family Welfare in Bangladesh. The proposal aims to clarify and focus the HEU's mandate on supporting universal healthcare through health economics analysis and policy guidance. It recommends refocusing the HEU's activities, limiting its scope by relocating certain units, renaming it the Directorate General of Health Economics and Policy, and establishing four new technical units. It also addresses staffing limitations and the need to strengthen collaboration to effectively implement the proposed changes.
The document outlines ACHAP's strategic plan for 2015-2020. It begins with ACHAP's vision, mission,
and core values. It then analyzes the current situation, noting that faith-based organizations operate
30-70% of health facilities in Africa but often remain unrecognized. ACHAP was established in 2007
to advocate and build networks among Christian health associations. The strategic plan aims to
better equip ACHAP to advocate, negotiate contracts, support members, coordinate synergies, and
provide leadership over the next 5 years.
The document summarizes a stakeholder workshop on a Joint Strategic Needs Assessment (JSNA) for transport and health in Cambridgeshire. The workshop discussed what a JSNA is, background and aims of the transport and health JSNA, and key topics of access and health, active transport, and air pollution. Attendees provided input on local issues, initiatives, and solutions for each topic. Next steps outlined forming working groups to analyze data and produce the JSNA to inform local decision-making.
HSFR/HFG End of Project Regional Report - AmharaHFG Project
The document discusses health care financing reforms implemented in the Amhara region of Ethiopia with support from the USAID-funded HSFR/HFG project. The reforms aimed to improve access to and quality of health services. Key reforms included establishing governing boards at health facilities, allowing facilities to retain and utilize generated revenue, and recruiting financial management staff. As a result of these reforms, the number of facilities with governing boards increased from 776 to 891, and the number implementing revenue retention doubled from 2013 to 2018. Revenue retained also increased substantially over this period.
1) The document summarizes the findings of a rapid capacity appraisal conducted in Niger State, Nigeria to assess progress in malaria control capacity after 5 years of support from the Support to National Malaria Programme (SuNMaP).
2) It finds that while some improvements have been made in areas like monitoring and evaluation and program management, capacity remains weak, especially in areas like disease surveillance and regulation. In particular, most staff in the state malaria control program have low qualifications.
3) Key recommendations include increasing government funding for malaria control, strengthening data management systems, ensuring technical assistance builds state capacity, and supporting establishment of a drug management agency.
The USAID Health Finance and Governance project, led by Abt Associates, works with developing countries to expand access to healthcare. It helps countries increase domestic health funding, better manage those resources, and make wise purchasing decisions. The project has worked in Cote d'Ivoire since 2013 to address challenges in human resources, health financing, and governance that were preventing effective delivery of HIV and other health services. Key accomplishments include a six-fold increase in the number of health workers trained to provide HIV treatment through task-sharing policies and curriculum changes.
Kathy Kunkle is a Human Services Program Specialist Administrator for Ingenesis, Inc. in Harrisburg, PA. Her role involves developing policies and procedures for Pennsylvania's statewide Nursing Home Transition program. She collects and analyzes data to track program outcomes and ensures compliance with regulations. Kunkle has experience in case management, billing, and administration for human services programs. She previously worked in construction and retail management.
The USAID Health Finance and Governance project in Angola helped the Ministry of Health develop a costed National Health Plan and monitoring and evaluation system to better advocate for health funding. Specifically:
1) HFG assisted MINSA in calculating a 12-year $6.3 billion budget to implement the National Health Plan, which helped gain approval and political support for increased health funding.
2) An M&E plan was developed and led to the creation of an M&E department at MINSA to track health spending and sector progress.
3) Efforts were made to establish a health accounting system to measure how funds are actually spent, but this was not completed due to a change in government leadership.
Essential Package of Health Services Country Snapshot: ZambiaHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Essential Package of Health Services Country Snapshot: The Republic of South ...HFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
This document provides an overview of district health planning in India. It defines district health planning and explains its purpose to improve health services and match limited resources to needs. A brief history is given of decentralized planning starting in India's first five-year plan. Key components of district health planning are identified, including situation analysis, priority setting, annual facility plans, and developing a district health action plan. The planning process involves different committees at village, block and district levels. The document provides an example of strengthening routine immunization for migratory populations in Gurgaon district.
The document discusses gaps in Myanmar's health system that hinder progress on MDG goals related to child mortality. It identifies gaps in service delivery, program coordination, and human resources. The Health Systems Strengthening goal is to improve essential health services for mothers and children by strengthening coordination, planning, and human resources management. Key activities include expanding service access in remote areas, developing guidelines for coordinated township health plans, researching effective health financing schemes, and ensuring adequate staffing levels according to national standards. Outcomes will be measured by coverage indicators like DTP3 and skilled birth attendance rates.
Guidebook for Enhancing Performance of Multi Purpose Workers Nishant NHSRCNishant Parashar
This document provides guidelines for enhancing the performance of Multi-Purpose Workers (Female) or MPW(F), who provide primary healthcare services at Sub Centers in India. It includes a prototype weekly work plan that outlines the activities MPW(F)s should carry out at the Sub Center, during Village Health and Nutrition Days (VHNDs), and on field/home visits. It also provides checklists for monitoring activities and assessing MPW(F) performance. The goal is to help MPW(F)s better organize their work and help supervisors evaluate individual performance, with the overall aims of improving healthcare delivery and outcomes at the Sub Center level.
Lessons from pfm in the health sector finalHFG Project
Over the past five years, the Health Finance and Governance (HFG) project has supported over 35 countries and programs in their efforts to strengthen public financial management (PFM) systems. Activities have been tailored to address key priorities within a health system context, and have ranged from improving financial data systems to conducting costing exercises, financial analyses, and capacity-building workshops. Across these activities, several lessons have emerged.
Insights in this brief stem from analysis of over 200 HFG financing activities; interviews with stakeholders from Ukraine and Vietnam; and experience from cross-cutting program activities. These lessons are shared as a resource for fellow implementing partners, country practitioners, and donor agencies. As the project ends, this brief considers the global context and established frameworks for PFM alongside the contributions of the HFG experience, and suggests a way forward.
Here are the short answers to the questions:
1. NHM stands for National Health Mission. It is an overarching program that encompasses the National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM).
2. NRHM stands for National Rural Health Mission. It aims to provide accessible, affordable and quality healthcare services to rural populations, especially vulnerable groups.
3. NUHM stands for National Urban Health Mission. It aims to improve health status of urban poor populations by facilitating their access to primary healthcare.
4. The main components of NHM include Reproductive-Maternal-Neonatal-Child and Adolescent Health (RMNCH+A), health systems strengthening, control
The National Health Mission (NHM) encompasses
its two Sub-Missions, the National Rural Health
Mission (NRHM) and the National Urban Health
Mission (NUHM). The main programmatic
components include Health system strengthening
in rural and urban areas, ReproductiveMaternal-Neonatal-Child and Adolescent Health
(RMNCH+A) and Communicable and NonCommunicable Diseases. The NHM envisages
achievement of universal access to equitable,
affordable & quality healthcare services that are
accountable and responsive to people’s needs.
RSSH Service Delivery Innovation (component 3 - HRH_QI)_AR.pptxKarenZamboni
The document summarizes a strategic initiative to improve health services in 5 West and Central African countries through investments in human resources for health (HRH) planning and quality improvement (QI). It describes 3 objectives: 1) improve HRH information for planning, 2) improve quality of care through integrated supervision and QI, and 3) strengthen leadership and management. Key activities include conducting HRH analytics to inform staffing, implementing integrated supportive supervision with a focus on collaborative improvement, and training health workers. The overall goal is to strengthen health systems and improve outcomes for HIV, tuberculosis, and malaria.
Management Assessment of the Secretary General’s Office in the Malian Ministr...HFG Project
In 2015, USAID/Mali and the government of Mali requested the HFG project to conduct a Management Assessment of the office of the Secretary General (SEGAL) in the Ministry of Health and Public Hygiene. The SEGAL’s office provides senior guidance, oversight, and control to the full range of the ministry’s health programs and activities. The SEGAL and his five Technical Advisers supported by three seconded technical specialists constitute the senior operating level of the Ministry of Health and Public Hygiene. This number is insufficient to accomplish all that is required of the SEGAL office. The Management Assessment provided in-depth analysis and recommended steps over the short, medium, and long term to address issues including the optimum number of SEGAL’s team and potential changes in organization and process that will permit the office to efficiently and effectively fulfill its responsibilities.
The work began with designing the Management Assessment to incorporate the SEGAL’s priorities e.g. the number and composition of his senior Technical Advisers so that the Office would better understand the changes needed to increase its managerial effectiveness in its oversight of Mali’s health programs.
The Management Assessment found that existing Technical Advisors spent up to 60% of their time on unplanned and unforeseen tasks, preventing them from focusing on strategic tasks that they are supposed to do. Such findings led the Ministry to use its own resources to recruit three new technical advisors to alleviate the workload of the SEGAL office, and to increase efficiency through a reallocation of tasks within the team. The Management Assessment provided evidence of the added-value of the Technical Advisors and the justification to depart from the government hiring freeze in place at the time.
Design and Implementation Options for a Central Procurement Unit and ARV Fina...HFG Project
The Ministry of Health (MOH) on behalf of the Prime Minister of Vietnam has therefore requested that the Health Finance and Governance (HFG) project present a proposal for the introduction of a Central Procurement Unit (CPU) for pharmaceutical products (including ARVs) offered in the public health system. However, the design, governance, and implementation of a CPU are not yet clear. HFG also is to identify practical, short- and long-term options for domestically financing and purchasing ARVs. While the CPU is expected to be Vietnam’s long-term vehicle for procuring ARVs, the GVN needs financing strategies that address methods for generating new (or existing) ARV resources and improving efficiencies through ARV payment and reimbursement mechanisms.
This document summarizes a programme review meeting for UNFPA's Cross River MIDC Programme in December 2017. It includes:
- An outline of agreed activities and their implementation status by output. Most activities were completed or partially completed.
- 2017 mid-year implementation rates that show the programme and financial implementation rates were both over 90%.
- Results achieved including increasing the number of health facilities providing family planning and increasing reporting on NHMIS.
- Key challenges like late receipt of funds and changes in leadership. Suggested interventions include early release of funds.
- Good practices like integrated distribution of medicines and conducting a joint data quality assessment.
- Success stories and lessons learned, and a
The document provides guidelines for human resource development procedures within the Ministry of Health in Kenya. It establishes several bodies responsible for coordinating training at the national and county levels, including the Authorized Officer, the Department of Human Resource Management and Development, and the Ministerial Human Resource Management Advisory Committee at the national level. The guidelines outline the composition and functions of these bodies, and provide standard operating procedures for key areas of human resource development such as planning and approval of training, bonding and scholarships, and monitoring and evaluation.
This document summarizes a study on health workforce retention initiatives in Ethiopia. It finds that:
1) There are policies and strategic plans for retention at the national and sub-national levels, though implementation varies. Financial incentives like professional allowances are common, though eligibility varies by region and facility.
2) Common financial incentives include professional allowances for specialists, general practitioners, midwives, and others. Rates vary significantly between regions and facilities. Positional allowances are also used but eligibility differs in each location.
3) Non-financial incentives are also used but to a lesser extent. Overall there is variation in retention schemes between locations within the country. The report recommends standardizing and regularly updating policies
Original Introduction 11 Nov 2015 ETR Malawi MissionJoke Hoogerbrugge
This document provides an introduction and background on an end-term review of the Support to Improved Nutrition Status of Vulnerable Groups in Malawi (SINSM) program. The review assessed the program's performance from October to November 2015 in 10 districts of Malawi. The program aimed to improve nutritional status through improved service delivery systems. It consisted of two phases from 2011-2014, with activities related to nutritional product distribution, capacity building, surveillance, rehabilitation, and coordination. The review sought to assess relevance, effectiveness, efficiency, impact, sustainability and coherence of the program. It was constrained by only having 9 days to visit 10 districts. The methodology and limitations of the review are discussed to provide credibility to the conclusions.
This document provides an evaluation report of the "Improving Quality of Health Care Services in Khyber Pakhtunkhwa" project from 2009-2015. The evaluation assessed implementation of healthcare standards at primary and secondary facilities in selected districts. It found that implementation of primary standards ranged from 9-26% across districts, while secondary standards implementation was around 16% in most districts. Client and provider satisfaction was higher in facilities where project interventions improved infrastructure and working conditions. Financial analysis showed under-spending in early years but increased expenditure in the final year, with most funds spent on infrastructure improvements. Qualitative findings indicated weak implementation initially due to funding mechanisms and monitoring, but improved after responsibility shifted to district health managers.
David Buck on improving the allocation of health resources in England The King's Fund
David Buck, Senior Fellow in Public Health and Inequalities at The King’s Fund, explains how health resources are allocated in the English NHS, and how improvements to the process could be made to support a more coherent health and care system.
Botswana Health Accounts 2013-2014: Statistical ReportHFG Project
This methodological note provides an overview of the System of Health Accounts 2011 framework used for the 2013/14 health accounts (HA) exercise. It provides a record of data collection approaches and results, analytical steps taken, and assumptions made. This note is intended for government HA practitioners and researchers.
The Botswana 2013/14 HA exercise was conducted between July 2015 and September 2016. The study covers the 2013/14 fiscal year (1 April 2013–31 March 2014). In mid-2015, the HA team, with representation from the Government of Botswana, the Health Finance and Governance (HFG) project, and the World Health Organization (WHO), began primary and secondary data collection. Collected data were then compiled, cleaned, triangulated, and reviewed. Data were imported into the HA Production Tool (HAPT) and mapped to each of the System of Health Accounts (SHA) 2011 classifications. The results of the analysis were verified with the Health Financing Technical Working Group on 9 October 2016 and the Ministry of Health and Wellness (MoHW) management on 10 October 10 2016. Participants involved in the production and validation of the results, and recommended for future HA workshops, are listed in Annex A.
This document describes best practices for strengthening community health information systems in Kenya. It discusses how the MEASURE Evaluation PIMA project provided support to the Community Health Services Unit. Key activities included:
1) Conducting a baseline assessment that identified needs to improve data quality, timeliness of reporting, and data use.
2) Developing partnerships to coordinate stakeholders and create monitoring and evaluation tools, standards, and guidelines.
3) Supporting community units and establishing Centers of Excellence to build skills for community health committees and workers, conduct learning visits, and promote data-driven community action.
4) Developing a national M&E plan and aligning county plans to establish an integrated, decentralized system
Community Health Strategy Implementation Guide 2007chskenya
This is the community Health Implementation guideline for CHS Kenya. Community Health Services Kenya is the body mandated to offer quality health services to Kenyans at community level. This guideline outlines how the strategy is implemented to ensure that each Kenyan has access to quality health services
For More Information Visit http://chs.health.go.ke
This document outlines the training management cycle used by a health organization. It includes 5 components: 1) Needs assessment to identify gaps, 2) Annual training plan development, 3) Implementation of individual trainings following preparation, planning, and implementation steps, 4) Assessment of trainings through short and long-term evaluations, and 5) Recording and reporting on training outcomes to inform future planning. The needs assessment uses various methods like questionnaires, reports and discussions. Individual trainings are implemented according to a curriculum and involve lectures, practice, and assessment. Evaluations are conducted before, during, and after training to assess knowledge and skills.
Trainers have to understand adult learning principles20 julyThurein Naywinaung
Trainers must understand adult learning principles to effectively teach adults. Some key principles include:
- Adults retain more information when they are actively involved through activities like role plays and discussions rather than passive listening.
- Learning should be relevant to adults' real-life needs and experiences.
- Adults learn best when new concepts are connected to their existing knowledge through techniques like questioning before providing answers.
The document discusses essential characteristics of effective national health plans. It outlines that national health planning has evolved from being led by health ministries to becoming more multidisciplinary and multi-sectoral. Key aspects of effective national health plans include the country context, the planning process, and plan content. The planning process should involve situation analysis, consultation, implementation, monitoring and evaluation. Plan contents should include vision, policies, strategies, programs and services to achieve universal health coverage. Challenges include weak health information systems, limited multi-sector engagement and financing gaps.
Management involves efficiently using resources and people to achieve objectives. It is a systematic process that includes planning objectives, taking action through people, and assessing the effects of actions. The key aspects of management are planning, organizing, leading, and controlling. An organization transforms inputs into outputs through various activities and processes. Management has many branches that can be applied in different contexts such as technology management, human resource management, and logistics management.
The document discusses several issues related to health workforce planning, production, and management in developing countries. Some key points include:
1) Health workforce planning seeks to ensure the appropriate number, distribution, skills, and motivation of health workers to deliver healthcare.
2) Issues like mismatched training and jobs, lack of rural positions, and emigration of physicians hamper effective health workforce management.
3) Factors like education, management, financing, policy, partnerships, and leadership influence a country's ability to develop, sustain, and optimize its health workforce.
The document discusses health care financing in Myanmar. It outlines the goals of a health system to provide good health outcomes, responsiveness, and fairness in financing. It then describes the various methods of health care financing in Myanmar including tax-based public financing, user fees, social security benefits, out-of-pocket payments, donor funding, health insurance, and community-based health insurance. It notes that Myanmar aims to explore alternative financing systems to augment roles of other providers and strengthen universal coverage while protecting people from financial hardship due to illness.
This document provides an overview of health systems and their development and strengthening. It defines a health system and its key goals of good health outcomes, responsiveness, and fairness in financing. The six building blocks of a health system are described as service delivery, health workforce, information, medical products/vaccines/technologies, financing, and leadership/governance. Health system strengthening is defined as initiatives that improve one or more of these functions to enhance access, coverage, quality or efficiency. The document discusses challenges faced by health systems and some opportunities to address them.
This document outlines a health system development programme in Myanmar from 2006-2011. It had three main objectives: 1) Promote health systems research to improve performance; 2) Explore sustainable health financing mechanisms; 3) Expand international cooperation. The programme included three projects: 1) Health systems research; 2) Developing alternative financing; 3) International health cooperation. It identified strengths like disseminating research and developing tools, but also weaknesses like lack of funding and dissemination of findings. The programme aimed to address gaps in service delivery, coordination, and human resources to improve access to essential health services.
This document outlines a health system development programme in Myanmar from 2006-2011. It had three main objectives: 1) Promote health systems research to improve performance, 2) Explore sustainable health financing mechanisms for equitable services, and 3) Expand international cooperation in line with their long term health plan.
The programme consisted of three projects: 1) A health systems research and development project, 2) A project developing alternative health financing mechanisms, and 3) An international health cooperation project.
Key strengths identified for health systems research included disseminating research skills and developing tools for strengthening the health system. Strengths for health financing included initiating assessments and exploring new financing schemes. Weaknesses identified lack of funding support for research
This document discusses sex and gender as they relate to health. It defines sex as the biological differences between men and women determined at birth, while gender refers to the social roles, behaviors, and attributes placed on men and women within a culture. It describes how gender influences health across the lifespan, with women facing greater health burdens due to biological and social factors like childbearing, gender-based violence, and lack of autonomy over healthcare decisions. The document presents a framework for measuring access to quality, gender-sensitive healthcare that considers the comprehensiveness of information provided, services offered, respect for human rights, technical competence, and healthcare infrastructure and facilities.
The document discusses sex and gender. It defines sex as the biological differences between males and females determined at birth, such as reproductive organs and ability to bear children, which do not change. Gender is defined as the social and cultural roles, behaviors, and attributes placed on males and females in a society, which can change over time and vary between cultures. The document provides examples of sex characteristics like menstruation and voice changes during puberty. Gender roles and expectations like career choices, household duties, and parenting roles are influenced by societal and cultural norms. The document outlines how gender influences health across the lifecycle from birth through adulthood and old age due to both biological and social factors.
This document discusses gender differences in tobacco use patterns and how the tobacco industry markets differently to women and men. It notes that while smoking rates have peaked in men, they are still rising in women. The tobacco industry uses gender stereotypes and images of independence and beauty in advertisements targeted towards women in magazines. Protecting both women and men from gendered tobacco marketing and ensuring gender-sensitive tobacco control policies are important aspects of reducing tobacco use worldwide.
1) The document discusses the differences between sex and gender, where sex refers to biological differences while gender refers to roles and identities that are socially constructed.
2) It explains that gender roles and expectations can lead to inequalities in areas like power, decision making, assets, and freedom between men and women.
3) The roles and responsibilities assigned to men and women are context specific and can change over time across cultures and societies.
This document summarizes CEDAW-related health implementations in Myanmar. It discusses how Myanmar aims to eliminate health discrimination against women through gender-specific services for pregnancy and implementing General Recommendations 14, 15, 19, and 24 of CEDAW. This includes combating HIV/AIDS through prevention and treatment programs, addressing gender-based violence, harmful traditional practices, and women's reproductive health and rights. The Ministry of Health collaborates with various partners to provide healthcare in line with international commitments like CEDAW and MDGs.
Management involves planning, organizing, leading and controlling resources to achieve organizational goals. It includes utilizing human, financial, and material resources efficiently through processes like decision making, coordination, and budgeting. There are various branches of management like human resource management, operations management, and knowledge management. Effective management requires competencies such as self-management, strategic thinking, communication, teamwork, and leadership. Key aspects of leadership include vision, honesty, respect, and empowering followers through trust and collaboration.
This document outlines a framework for measuring women's access to quality, gender-sensitive health services. The framework includes 5 components: 1) Comprehensiveness of information, 2) Comprehensiveness of women's health services, 3) Respect for women's human rights, 4) Technical competence of providers, and 5) Infrastructure and facilities. Each component contains several indicators to assess gender equality and women's human rights in health services, such as availability of women providers, informed consent practices, integration of related services, and infrastructure meeting gender needs. The framework aims to evaluate health services based on women's experiences and promote equitable, rights-based care for women.
- The document discusses the implementation of a Maternal and Child Health (MCH) Voucher Scheme and Hospital Equity Fund (HEF) in Myanmar to improve access to essential maternal and child health services for poor families.
- The MCH Voucher Scheme will provide vouchers to cover costs of antenatal care, delivery, and postnatal care services for poor pregnant women. The HEF will cover costs of emergency transport, procedures, and hospital stays for poor mothers and children requiring emergency or life-saving care.
- Initial data on expenditures through May-July 2012 from several pilot townships shows that the funds are being used to cover costs of services, drugs, transportation, and accommodations for beneficiaries
This document summarizes the implementation of a package tour by midwives to provide health services in remote villages in Myanmar. The midwife describes traveling long distances by public bus, cycle taxi, and walking for 7 hours to reach Bawgahta subcenter. Health services like antenatal care, immunizations, weighing children, and health education are provided through group activities. Strengths include providing multiple services in one visit and reaching unserved villages. Constraints include the time needed to gather communities, lack of cooperation from village authorities, difficult travel during rainy season, inadequate supplies, and missed deliveries while traveling between villages.
This document summarizes the health supervision activities carried out by U Htun Lwin, a health assistant at Ngaphyugalay Rural Health Center in Thayarwaddy, Myanmar. It describes the supervisor's visits to 4 subcenters between January and June 2012 to monitor infrastructure, services, and community participation. The supervision identified areas for improvement like sanitation facilities and midwife collaboration. It also led to rebuilding a subcenter and holding health education sessions. The supervision strengthened midwife motivation and data quality but had weaknesses in technical skills and follow-up.
The document summarizes activities conducted as part of the GAVI-HSS assessment in Bhamaw and Shwegu townships. Eight system areas were surveyed including health management, human resources, finance, and data quality. Hard to reach villages were identified for package of health services including immunization, MCH care, nutrition, and health education. Status updates on implementation of package of services show progress made in visiting identified villages, as well as coverage indicators like ANC and SBA rates. Challenges faced and areas for improvement are also discussed.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
1. Minutes of 2nd NHSC Meeting
(29-12-2011)
The 2nd NHSC meeting was conducted on the 29 th of December 2011, in the Department of Health’s Conference
hall, with the key objective to:
1.
2.
3.
4.
Update the NHSC members on the implementation of GAVI HSS activities and expenditure status for the last three
months.
Seek NHSC’s endorsement on the GAVI HSS work plan for next three months.
Present the process of drafting Coordinated Township Health Plans (CTHP) for the first twenty townships and share
broad findings from the Health system assessments to the NHSC members.
Seek NHSC’s endorsement on the Coordinated Township Health Plans for the first twenty townships for
implementation
Members present (list attached):
Agenda 1: Opening Speech by Chair NHSC:
Deputy Director General, Disease Control, Department of Health chaired the meeting on behalf of the Director
General, DOH. Chairperson welcomed the members of NHSC to the 2 nd NHSC meeting and shared his best
wishes for the New Year. In his opening speech, he acknowledged the GAVI Focal (Director, Planning, and
Department of Health) and the team for the job well done. He also informed very briefly to the members about
the process of drafting the CTHP which took a bottom-up and participatory approach by involving all the health
workers from Township and Rural Health Centers. The chairperson also said that the added value of CTHP is
best demonstrated through iterative costing of the plan.
Initiatives on demand side financing through the development of Maternal Voucher Scheme and Hospital Equity
Fund were also highlighted as some of the health system interventions undertaken to improve the access to
essential maternal and child health services.
The Chairperson then opened the floor to deliberate further. He urged the members to share their opinions and
strategic ideas to guide the Ministry of health to sustain the Health System Strengthening interventions.
Agenda 2: Update on GAVI HSS activities, Assessment and CTHP, Update on GAVI missions and their
suggestions/recommendations, Expenditure update and GAVI work plan for next three months.
Dr. Nilar Tin, GAVI Focal Point (Director Planning, DoH) updated the members on GAVI HSS activities
implemented in the last three months. Her presentation emphasized much on the process and steps adopted in
drafting CTHPs. The CTHP for one of township was presented as an example, for the members to understand
better.
Further, broad findings from the Health System Assessments on Human resource and Infrastructure were
presented to the forum. The presentation demonstrated pictorial formats of the hard to reach areas, manual
recording of the health information and data’s in the sample townships.
1
2. Minutes of 2nd NHSC Meeting
(29-12-2011)
Nonetheless, the presentation could not display the detailed analysis of the findings on Health financing;
Human Resource, Data Quality and service quality, since analysis on these findings were still under process.
However, the forum was informed that detailed findings from the assessments will be shared in the next NHSC
meeting.
Dr. Nilar Tin also informed the forum about the recruitment of health System Strengthening officers (HSSOs)
and their contribution in conducting Health systems assessments and drafting of CTHPs. She said, they will be
involved in implementation of CTHPS, monitoring and supervision and financial management. In addition to
that she said; HSSOs will be reporting to the concerned departments/agencies through the GVAI Focal on any
problems observed in their townships with recommendations.
In order to facilitate them in performing these additional tasks, she said, HSSOs were given technical briefing by
the specific technical departments (Epidemiology (EPI), MCH, Health Financing, Health Information, on 27 th and
28th of December 2011.
The second half of her presentation made an update on the GAVI mission that visited Myanmar from 15-17 th
November 2011. Presentation highlighted the key discussions with the Mission as follows:
o
New vaccine application of Myanmar (Penta) and related co-financing and financial
sustainability issues.
o
Cold chain status and plans.
o
HSS implementation and 3rd party identification issues
o
Financial Management Assessment (FMA) and the Aide Memoire
o
Liaise with other Partners, DFID and AusAID.
The members were informed on the issues in implementing the infrastructure component. She mentioned that
the previous proposal that was drafted in 2007 did not include management cost and forecast inflations and
exchange rate fluctuations. Now the proposal from 3 rd party includes management cost which is quite high
consuming approximately 20 % of the planned budget. Further, 3 rd party’s cost projection using UN standards
shows financial gap and huge cost hike. That further shows reduction in number of product delivery (renovation
of RHCs and constructions of sub- RHCs).
Following this her presentation flagged some of the suggestions received from the mission on Infrastructure
component and GAVI HSS’s governing body. The suggestions were presented to the members for their
guidance.
On infrastructure: she highlighted that GAVI suggested reprogramming the infrastructure component to
priority areas linking to country’s current policy.
2
3. Minutes of 2nd NHSC Meeting
(29-12-2011)
On GAVI HSS’s governing body: she highlighted that GAVI suggested either clubbing ICC and HSS or using CCM
as the governing body.
In the final segment of her presentation, Dr. Nilar Tin briefed the forum on activities planned for next three
months for endorsement with the overall expenditure status till date. The main activities planned for next
three months were:
Analysis, Compilation and documentation of HSS assessments reports.
Implementation of CTHPs in 20 townships
Provision of basic PHC service and essential health supplies to HTR areas.(recurrent cost
covered),
Supply transport capital to 20 townships as identified in CTHP.
Community involvement (Health Committee activities-Quarterly Review Meeting),
Development and production of policy brief and guidelines for initiation of Maternal Voucher
Scheme (MVS)
Advocacy meeting & training for central level and township on MVS
Training/recruitment of CHW/AMWs in HTR areas(20 tsps)
Refresher training for CHWs in 20tsps.
Actual overall expenditure incurred was presented as 21%, however she explained that it is as per the
statement generated from WHO system which displays only the liquidated expenses. Nonetheless, the actual
expenses would be around 50% including the un-liquidated expenses.
Discussion:
•
Medical officer from WHO supported the implementation of such activities that facilities access for the
community living in hard to reach areas to achieve the MDG goals. He said, findings from the assessments are
also expected to identify system constraints in the area of HR, Infrastructure, Financing and health information
that would be brought to the notice of policy makers to consider policy actions. Saying that, he submitted
WHO’s concurrence on endorsing the CTHP and GAVI HSS work plan for next three months for implementation.
•
The chair person enquired whether CTHP and assessment looked at covering the migrant workers and
immigrants to address cross border issues.
To this the GAVI Focal (Dr. Nilar Tin) responded that all these issues were considered to cover the whole
township. During the assessment specific example was found in Sgwe Gu township where the workers from the
mines who were staying around the township yet they were found to be inaccessible to the township hospital
and public health care services as they were migrant workers from different townships.
-
•
Representative from MERLIN asked on the management of the CTHPs; the role of central and states/regions in
longer run once the coverage is expanded from 20 townships and beyond. Further he also asked whether all
the actual costs are included in the plan.
3
4. Minutes of 2nd NHSC Meeting
-
-
•
-
(29-12-2011)
The members were informed by the GAVI Focal (Director, Planning, DoH) that in longer run the states and
regions are expected to take more responsibility in managing the CTHPs, with central only giving technical
support when needed. She also informed the forum on the upcoming plan to conduct leadership and
management training to upgrade the capacity of state and regional health directors on planning and
management.
Regarding the query on costing, she explained the difficulty to include all the foreseen cost, rather she said;
costing is done for the priority activities and interventions in negotiations with the BHS and other health
workers.
The representative from MERLIN recommended sensitizing the developing partners and NGOs on the CTHP
through dissemination meeting.
Chairperson noted this recommendation as valid and suggested dissemination of the CTHPs through
appropriate forums for further collaboration.
•
Chairperson enquired whether any discussion was held with the township health workers on their plans to
sustain the provision of package of services once the program phases out. He also highlighted it will be
important to think through these areas to maintain sustainability. Responding to this query, the GAVI Focal
(Director Planning, DoH), mentioned that initially it’s very important to motivate and incentivize the basic
health staff to initiate the new approach. CTHP approach will be implemented with the intention to test its
feasibility and if found feasible, the findings shall be brought to the notice of policy makers for
institutionalization of hardship allowances/ per diem or increasing transport allowances in the government
system.
•
The forum expressed the need to have more inputs to strengthen and improve the Health system components
mainly the HR, Health Financing components/policies.
-
To this effect GAVI focal shared other ongoing activities on the Assessment of HR retention that is expected to
demonstrate ground realities and issues on the Human Resource Management and Retention. Further she
highlighted other activities on demand side financing like provision of seed money to hospital equity fund and
Maternal Voucher Scheme which are in pipeline.
•
The EPI Director expressed the need to discuss the Infrastructure component. He said it would be important to
think about reprioritizing this fund to priority areas. Due to the fluctuation in exchange rate and inflation,
around 25% of projected budget will be lost if the fund is to be used for infrastructure building. Further, he also
enquired the possibility of re-channeling this fund to support the implementation of Penta vaccine next year.
On the suggestion to club ICC and NHSC, he suggested keeping them separate as of now and, NHSC can oversee
GAVI HSS while ICC will oversee the EPI activities. He also enquired the possibility of including micro plans for
EPI in the CTHP.
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5. Minutes of 2nd NHSC Meeting
(29-12-2011)
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On the infrastructure component, Dr. Nilar said, discussion/negotiation is still ongoing with UNOPs and if at all
the management cost doesn’t come down, then reprioritization can be done as per the current health system
need and government policy.
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GAVI Focal (Director, Planning, DoH) said, noting the need to involve partners from other development partners
like DIFID and USAID in the NHSC, Honorable Minister endorsed the proposal to incorporate their
representation in the NHSC as members.
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On the query to capture micro plan for EPI in the CTHP, the Chairperson expressed the impossibility of
incorporating all the micro plans for different programs in the CTHP and he further recommended the programs
to prepare separate micro plans for specific programs.
Decision and Recommendation by Members:
After detailed deliberation on CTHP, the infrastructure component and clubbing of ICC/HSS or using CCM as the
governing body. Following decision and recommendations were made:
1. It was recommended to disseminate the CTHPs to the other development partners through appropriate
forum to facilitate further collaboration and support.
2. On the clubbing of ICC/HSS or using CCM as the governing body, it was recommended to do proper analysis
to assess the value addition and the challenges on this. Following that a proposal may be submitted to the
ministry for policy directives. It was then decided to follow the current practice: Keep NHSC and ICC
separate, with NHSC overseeing the GAVI HSS and ICC overseeing the EPI components, until further
directive is received from the ministry.
Agenda 3: Update on Technical support by WHO
Medical Officer from WHO briefed the forum on the commitments by WHO in the Aide Memoire as follows:
o
Overall management and administration of the GAVI HSS funds for the HSS programme and activities
contained in the GAVI HSS proposal excluding construction and renovation of health centers and
procurement of supplies and equipment.
o
Technical assistance to all aspects of the programme including cross cutting support in capacity building,
research, planning and monitoring and evaluation.
o
Facilitate the recruitment of technical staff and international consultants as and when needed
Following this, he informed that WHO has assigned and recruited One Medical Officer, one International
Technical Officer, 2 National Technical officers, one Administration and Finance Officer, one Administration
Assistant, 2 Finance Assistants and one office secretary in WHO country office.
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6. Minutes of 2nd NHSC Meeting
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These staffs are basically mandated to facilitate GAVI HSS planning and reporting to WHO and GAVI. They are
facilitating coordination between (MoH, WHO and GAVI) and establish synchronization between the different
technical and administrative requirements of WHO, MOH and GAVI. They are providing necessary technical
support for implementation and management of GAVI HSS activities.
Further he mentioned, the recruitment 18 Health System Strengthening officers, 4 placed at the central level
and 14 in the townships. Health System strengthening officers are mandated to conduct HSS assessments,
CTHP drafting and Implementation. They will also over look the financial management at the township level
and further monitor and manage the fund flow from central to townships.
Ultimately he said, this whole team is working in close consultation and collaboration with the GAVI focal point
(Director, planning, DOH) who is leading the GAVI HSS initiatives in Myanmar.
No further discussion was raised on this agenda.
Agenda 4: Status update on UNICEF Component of GAVI HSS:
The representative from UNICEF presented the status update on the supplies till date. Kits for medicine and
equipment are in the pipeline and will soon reach the CMSD for further distribution to 20 townships.
Discussion:
•
Considering the variation in catchment population which will drive the utilization rate, members raised
concerns on the disbursement of same amount of kits to all the townships. The concerns were in relation to
management of surplus and shortage of kits.
-
-
•
Responding to this the UNICEF focal said, for this year Ministry of Health will accept whatever has been
dispatched by UNICEF. Further, UNICEF will rationalize the distribution from year two based on the report
on surplus and stock outs from the townships.
The chairperson also encouraged the HSSOs and TMOs to report on surplus and stock out to create baseline
for next distribution.
The members also urged the need to appoint someone at the central level to conduct close monitoring of
supply management.
-
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To this effect, GAVI focal informed that one Health System Strengthening Officer is already recruited at the
central to monitor and evaluate the supply management.
7. Minutes of 2nd NHSC Meeting
(29-12-2011)
Agenda 5: Presentation on Hospital Equity Fund:
GAVI focal Dr.Nilar Tin presented the objective and management plan of Hospital Equity Fund. Through her
presentation she informed the forum that this fund is indented to provide free hospital services to poor mother
and children. Through the GAVI HSS initiatives each hospital in the sample townships will be given a seed
money of $ 10,000(approximately 800, 0000 kyats). For each patient maximum budget of 100,000 kyats to
cover the food, transport and direct medical costs (consultation, investigation and drugs) for the poor mother
and children.
Discussion:
•
Representative from Myanmar Medical Association shared his experience on the Referral fund for the high risk
pregnant women in Northern Rakhine state. In his statement, he said such intervention can bring positive
changes. His experience showed nearly 100% turnouts of the high risk pregnant women to seek service.
Nonetheless, he said there is difficulty to sustain such measures in longer run. He therefore recommended to
advocate the outcome of such interventions to the policy makers and highlighted need to explore strategies to
generate additional funds from internal and external donors.
•
Chair of the Myanmar Maternal and Child Welfare Association said, on an average a woman has to spend
almost 40,000 kyats for referral services in Rakhine state. She said, currently MMCWA is planning to donate
money to the hospital equity fund to support referral services in many townships including the 20 GAVI HSS
townships.
•
Representative from the Office of the Auditor General requested GAVI focal to submit complete data and
information of the OA (other accounts) to the AG office.
•
Representative from Save the Children enquired whether Advocacy will be done to inform the community on
the Hospital Equity fund. To this Dr.San San Aye, Director of Health Planning and Dr.Nilar Tin Director Planning,
DOH clarified the prime objective of fund to support only the poor mothers and children visiting the hospital.
They said, advocacy is not encouraged basically to avoid moral hazard (unnecessary demand by both rich and
poor).
•
Former Deputy Minister for Health, who is currently the Member of Parliament (chairman of maternal and child
welfare committee of Myanmar) happened to attend the discussion at the end part of the meeting while
visiting the DOH. During the discussion he had given his vast experience in the management of maternal and
child health care and also given input for health financing component.
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8. Minutes of 2nd NHSC Meeting
(29-12-2011)
Closing Remarks by Chairperson:
In his closing remarks, the chairperson thanked all the members for attending the 2 nd NHSC meeting and making
constructive contribution in guiding the GAVI team to further implement the planned activities.
He formally endorsed the CTHP for the twenty townships and the GAVI work plan for next three months for
implementation. Also the Hospital Equity Fund was included in the endorsement.
The meeting adjourned at 12:30.
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