Health

Health systems in Sub-Saharan Africa have changed profoundly over the last 20 years. The economic crisis of the 1980s and 1990s rattled public health care systems, which... Show More + were largely holdovers from the colonial and postcolonial eras. The later wave of structural adjustments and public sector reforms wrought further change. As African economies opened to market based approaches, the private sector became a sizable source of health care service. Today about half the health expenditures in Africa are private, and private providers play a major role in the delivery of outpatient services. This is draws on the lessons, knowledge, and data gathered by the World Bank's Africa Region Human Resources for Health Program. For the first time, the various complexities of Human Resources for Health (HRH) labor markets are addressed comprehensively in one volume. Given the increasing demand in countries for strong health workforces that can help achieve universal health coverage; we hope this book will be beneficial to researchers, policy makers, and practitioners who are trying to develop evidence-based HRH interventions to achieve this end. Show Less -

The health equity and financial protection datasheets provide a picture of equity and financial protection in the health sectors of low-and middle-income countries.... Show More + Topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. The tables in this report show how health outcomes, risky behaviors and health care utilization vary across asset (wealth) quintiles and periods. The quintiles are based on an asset index constructed using principal components analysis. Benefit-Incidence Analysis (BIA) shows whether, and by how much, government health expenditure disproportionately benefits the poor. The distribution of subsidies depends on the assumptions made to allocate subsidies to households. Under the constant unit cost assumption, each unit of utilization is assumed to cost the same and is equal to total costs incurred in delivering this type of service divided by the number of units of utilization. Show Less -

Annually, Afghanistan loses over US dollar 235 million in GDP to vitamin and mineral deficiencies. Scaling up core micronutrient interventions would cost less than US... Show More + dollar 17 million per year. Overall prevalence of stunting and underweight have decreased over the past two decades and the country is currently on track towards meeting (halving 1990 rates of child underweight by 2015). Nevertheless, much remains to be done to accelerate reductions in underweight and reduce low birth weight to improve outcomes for future generations of children. Show Less -

Annually, Bhutan loses over US dollar 2.4 million in GDP to vitamin and mineral deficiencies. Scaling up core micronutrient interventions would cost US dollar 340,000... Show More + per year. Bhutan has similar high rates of stunting relative to its South Asian neighbors. Countries with comparable per capita incomes, however, exhibit lower rates of child stunting, which demonstrates the ability to achieve better nutrition outcomes despite low income. Bhutan also has higher maternal and infant mortality rates relative to income and health spending than all of its South Asian neighbors.14. This indicates that available funds can be used more effectively to benefit women and children's health and nutrition. Show Less -

Annually, Bangladesh loses over US dollar 700 million in GDP to vitamin and mineral deficiencies. Scaling up core micronutrient interventions would cost less than US... Show More + dollar 65 million per year. Overall prevalence of stunting and underweight has been decreasing over the past two decades, Bangladesh will not meet (halving 1990 rates of child underweight by 2015) with business as usual. Under nutrition is not just a problem of poverty. In the past 2 decades, Bangladesh has made considerable progress in development, sustaining high rates of economic growth and reducing poverty rates by 9% between 2000 and 2005. Show Less -

This policy brief summarizes the evaluation findings of a program in Zambia which sought to enable the private sector to play a stronger role in malaria diagnosis and... Show More + treatment. The poor in many countries lack access to essential malaria diagnosis and treatment methods. One of the reasons is many patients access malaria treatment through the private and informal sectors, where the availability of diagnostic tests and drugs can be limited and where prices for the recognized front line drugs artemisinin-based combination therapies (ACTs) are generally high. The program had two main components: (i) a subsidy for ACTs and Rapid diagunastic test (RDTs); and (ii) accreditation program based on Tanzania’s ADDO model. The main conclusion of the evaluation was that a well - managed intervention can strengthen access to ACTs through the private sector whilst also reducing the use of ineffective antimalarials. Show Less -

This book towards interventions in human resources for health in Ghana is a collaborative effort between the government of Ghana and the World Bank, was developed to... Show More + assist the ministry of health to obtain an overview of the unique human resources for health (HRH) challenges that Ghana faces. Evidence on the stock, distribution, and performance of health workers in Ghana, as well as on some of the underlying determinants of these HRH outcomes, will help support the government resolve to develop strategies and interventions to address HRH concerns and ultimately strengthen its health system. The content of this book was developed, discussed, and validated by means of extensive consultations with the technical working group on (HRH) in Ghana. This book contents totally eight chapters: chapter one covers toward evidence-based interventions for HRH; chapter two covers the stock of health workers; chapter three covers the distribution of health workers; chapter four covers the performance of health workers; chapter five covers Ghana Agencies and their roles and responsibilities in HRH; chapter six covers interventions to increase stock and improve distribution and performance of HRH; chapter seven covers financing available for policy and interventions; and chapter eights covers the political economy of crafting policy. Show Less -

Indonesia, like many middle income countries, has difficulty providing universal access to education and adequate access to healthcare, particularly in poor and rural... Show More + areas. To tackle these problems, the Government of Indonesia launched two large-scale programs in 2007. The programs both relied on cash transfers, but one targeted households and one targeted communities. In both cases, the transfers were designed to encourage families to meet basic health and education indicators, including prenatal visits for pregnant women, childhood immunization, regular weight monitoring, and school attendance. To push communities to focus on the most effective policies, a portion of subsequent year grants is based on how well communities do in meeting the previous year's health and education targets. In this way, the program takes aspects of conditional cash transfer and pay-for-performance programs and reformulates them to encourage community-wide performance and accountability. In order to test the effectiveness of linking grants to the previous year's performance, a second version of the program was carried out in which communities received the money irrespective of the previous year's performance. The grants have ranged from an average of $8,500 in 2007 to $18,200 in 2009. This World Bank supported program now reaches about 5.4 million people. Show Less -

Paying for performance provides financial rewards to medical care providers for improvements in performance measured by specific utilization and quality of care indicators.... Show More + In 2006, Rwanda began a paying for performance scheme to improve health services delivery, including HIV/AIDS services. This study examines the scheme's impact on individual and couples HIV testing and counseling and using data from a prospective quasi-experimental design. The study finds a positive impact of paying for performance with an increase of 6.1 percentage points in the probability of individuals having ever been tested. This positive impact is stronger for married individuals: 10.2 percentage points. The results also indicate larger impacts of paying for performance on the likelihood that the respondent reports both partners have ever been tested, especially among discordant couples (14.7 percentage point increase) in which only one of the partners is HIV positive. Show Less -

Animal diseases pose a profound challenge to global public health. Every year, 2.4 billion people in developing countries are infected by diseases with origins in animals... Show More + (zoonotic) and 2.2 million die as a result. These are not the pandemic illnesses like HIV/AIDS and influenza that are also zoonotic, and that that periodically dominate the headlines and command the attention of the international community. The prevention and control of zoonotic diseases is a global public good, and the very definition of a development issue with transboundary impacts. The international public health concerns generated by SARS, HPAI, and H1N1, laid bare the mutual dependency between countries near and far. This was an incentive to cooperation as no one country or even group of countries, could have faced these threats alone. It was also a reminder that no single sector or group of specialists can mobilize an effective global disease response. The Bank has much to offer, its contributions are unique and, without them, it is difficult to imagine a successful transition from sporadic emergency responses to the long-term systemic strengthening that will help protect the poor from high and growing risks and increase shared prosperity. Show Less -