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Donor financing to low- and middle-income countries for reproductive, maternal, newborn, and child health increased substantially from 2008 to 2013. However, increased spending by donors might not improve outcomes, if funds are delivered in ways tha
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t undermine countries’ public financial management systems and incur high transaction costs for project implementation
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Promoting and protecting health is essential to human welfare and sustained economic and social development. This was recognized more than 30 years ago by the Alma-Ata Declaration signatories, who noted that
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Health for All would contribute both to a better quality of life and also to global peace and security.
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Needs assessment and analysis
Collect and analyze sex, age and disability disaggregated data (SADDD) and conduct a participatory gender analysis to understand different health needs, capacities, barriers and aspirations and identify populations w
...
ith special health requirements
Population demographics. E.g. pregnant and lactating women, infants, elderly, unaccompanied children, persons with disabilities, chronically ill persons 9 Gender roles and power dynamics. E.g. ability of women, girls, men and boys to make health decisions and access services; roles and responsibility of household members in health.
Gender and cultural norms and practices. E.g. preference for mixed/segregated facilities and staff; socio-cultural and religious taboos and beliefs around health, practices and beliefs on menstruation, practices and expectations on pregnancy, childbirth and breastfeeding; traditional health care providers
Intersectional issues. E.g. access to health care for LGBTIQ persons, for GBV survivors, for adolescent girls and boys
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This guidance describes a catalogue of indicators for maternal, newborn, child and adolescent health (MNCAH) that can be monitored through health management information system data. It is a module o
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f the WHO Toolkit for Routine Health Information Systems (RHIS) Data and links to relevant indicators from other programmatic modules of the WHO toolkit. The document provides guidance on possible analysis and visualization of the indicators, including considerations for interpreting and using the data for decision-making. An annex on data quality considerations for MNCAH managers provides suggestions for reviewing and interpreting routine health facility data through a quality lens.
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Changes in climate, in conjunction with other drivers of mobility, shape human migration. While there is an increasing focus on the adaptive potential of migration, the health impacts of climate-related migration, including planned relocation and fo
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rced displacement, have not been thoroughly examined. The Intergovernmental Panel on Climate Change stated that migration is currently, and will increasingly be, influenced by environmental degradation and climate change, and that it needs to be addressed in a focused and coordinated manner
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South Sudan continues to struggle with a severe health crisis affecting 8.9 million people, primarily in flood- and conflict-affected regions with population movements (displacement and returns), and disease outbreaks. The nation's
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health system, heavily reliant on international aid, faces staffing and resource shortages. Vulnerable groups, including women, children, the elderly, and those with disabilities, have limited healthcare access and face heightened risks of mortality and illness.
The life expectancy at birth (55 years) is among the lowest globally, as mortality rates remain among the highest with neonatal, infant, under-five mortality rates estimated at 39.63, 63.76 and 98.69 deaths per 1000 live births respectively, and a maternal mortality ratio of 1,223 deaths per 100,000 live births. Although some disease specific mortality rates such as TB and AIDS-related mortality have declined, mortality due to malaria and non-communicable diseases have increased over the past five years.
The main causes of morbidity remain communicable diseases; malaria, is the top cause of morbidity (64%) and mortality (45%) among outpatients, followed by pneumonia and diarrhea.20 Several Counties report malaria cases above the threshold perennially especially during the rainy seasons, affecting mainly children under five years. The last malaria indicator survey (2017) estimated malaria prevalence of 32%, 34% and 18% among children under-five, protection of civilian’s sites, and internally displaced persons, respectively.
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The Disaster Recovery Framework (DRF) Guide for the Health Sector provides guidance on how to implement a comprehensive, integrated, and structured approach to disaster recovery. Its overarching goal is to minimize the impact of the disaster on comm
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unities and help countries to recover quickly and effectively from disasters, in coordination with key stakeholders.
The DRF Guide for the Health Sector is adapted from the generic DRF Guide, and draws on the Implementation Guide For Health Systems Recovery in Emergencies, the Health Emergency and Disaster Risk Management Framework as well as the Disaster Recovery Guidance Series. The guide also makes links with multi-sectoral, government-led recovery planning processes such as the Post-Disaster Needs Assessment (PDNA), and it supports the implementation of the HDPN.
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Background
Four methods have previously been used to track aid for reproductive, maternal, newborn, and child health (RMNCH). At a meeting of donors and stakeholders in May, 2018, a single, agreed method was requested to produce accurate, predictab
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le, transparent, and up-to-date estimates that could be used for analyses from both donor and recipient perspectives. Muskoka2 was developed to meet these needs. We describe Muskoka2 and present estimates of levels and trends in aid for RMNCH in 2002–17, with a focus on the latest estimates for 2017.
Methods
Muskoka2 is an automated algorithm that generates disaggregated estimates of aid for reproductive health, maternal and newborn health, and child health at the global, donor, and recipient-country levels. We applied Muskoka2 to the Organisation for Economic Co-operation and Development's Creditor Reporting System (CRS) aid activities database to generate estimates of RMNCH disbursements in 2002–17. The percentage of disbursements that benefit RMNCH was determined using CRS purpose codes for all donors except Gavi, the Vaccine Alliance; the UN Population Fund; and UNICEF; for which fixed percentages of aid were considered to benefit RMNCH. We analysed funding by donor for the 20 largest donors, by recipient-country income group, and by recipient for the 16 countries with the greatest RMNCH need, defined as the countries with the worst levels in 2015 on each of seven health indicators.
Findings
After 3 years of stagnation, reported aid for RMNCH reached $15·9 billion in 2017, the highest amount ever reported. Among donors reporting in both 2016 and 2017, aid increased by 10% ($1·4 billion) to $15·4 billion between 2016 and 2017. Child health received almost half of RMNCH disbursements in 2017 (46%, $7·4 billion), followed by reproductive health (34%, $5·4 billion), and maternal and newborn health (19%, $3·1 billion). The USA ($5·8 billion) and the UK ($1·6 billion) were the largest bilateral donors, disbursing 46% of all RMNCH funding in 2017 (including shares of their core contributions to multilaterals). The Global Fund and Gavi were the largest multilateral donors, disbursing $1·7 billion and $1·5 billion, respectively, for RMNCH from their core budgets. The proportion of aid for RMNCH received by low-income countries increased from 31% in 2002 to 52% in 2017. Nigeria received 7% ($1·1 billion) of all aid for RMNCH in 2017, followed by Ethiopia (6%, $876 million), Kenya (5%, $754 million), and Tanzania (5%, $751 million).
Interpretation
Muskoka2 retains the speed, transparency, and donor buy-in of the G8's previous Muskoka approach and incorporates eight innovations to improve precision. Although aid for RMNCH increased in 2017, low-income and middle-income countries still experience substantial funding gaps and threats to future funding. Maternal and newborn health receives considerably less funding than reproductive health or child health, which is a persistent issue requiring urgent attention.
Funding
Bill & Melinda Gates Foundation; Partnership for Maternal, Newborn & Child Health.
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A general consensus exists that as a country develops economically, health spending per capita rises and the share of that spending that is prepaid through government or private mechanisms also rises. However, the speed and magnitude of these change
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s vary substantially across countries, even at similar levels of development. In this study, we use past trends and relationships to estimate future health spending, disaggregated by the source of those funds, to identify the financing trajectories that are likely to occur if current policies and trajectories evolve as expected.
Methods
We extracted data from WHO's Health Spending Observatory and the Institute for Health Metrics and Evaluation's Financing Global Health 2015 report. We converted these data to a common purchasing power-adjusted and inflation-adjusted currency. We used a series of ensemble models and observed empirical norms to estimate future government out-of-pocket private prepaid health spending and development assistance for health. We aggregated each country's estimates to generate total health spending from 2013 to 2040 for 184 countries. We compared these estimates with each other and internationally recognised benchmarks.
Findings
Global spending on health is expected to increase from US$7·83 trillion in 2013 to $18·28 (uncertainty interval 14·42–22·24) trillion in 2040 (in 2010 purchasing power parity-adjusted dollars). We expect per-capita health spending to increase annually by 2·7% (1·9–3·4) in high-income countries, 3·4% (2·4–4·2) in upper-middle-income countries, 3·0% (2·3–3·6) in lower-middle-income countries, and 2·4% (1·6–3·1) in low-income countries. Given the gaps in current health spending, these rates provide no evidence of increasing parity in health spending. In 1995 and 2015, low-income countries spent $0·03 for every dollar spent in high-income countries, even after adjusting for purchasing power, and the same is projected for 2040. Most importantly, health spending in many low-income countries is expected to remain low. Estimates suggest that, by 2040, only one (3%) of 34 low-income countries and 36 (37%) of 98 middle-income countries will reach the Chatham House goal of 5% of gross domestic product consisting of government health spending.
Interpretation
Despite remarkable health gains, past health financing trends and relationships suggest that many low-income and lower-middle-income countries will not meet internationally set health spending targets and that spending gaps between low-income and high-income countries are unlikely to narrow unless substantive policy interventions occur. Although gains in health system efficiency can be used to make progress, current trends suggest that meaningful increases in health system resources will require concerted action.
Funding
Bill & Melinda Gates Foundation.
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Infectious disease epidemics pose a threat to reproductive, maternal, newborn and child health (RMNCH) both directly—by worsening women’s and children’s health outcomes—and indirectly—by r
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educing their access to services.1–4 Greater investment is therefore needed to mitigate the negative effects of COVID-19 and avoid a reversal of recent gains in RMNCH coverage and outcomes.1 However, COVID-19 has reduced household and government budgets,5 and there are concerns about the extent to which resources have been diverted away from RMNCH.
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Financial Assistance for Health Security: Effects of International Financial Assistance on Capacities for Preventing, Detecting, and Responding to Public Health Emergencies
Boyce, M.; Meyer, M.; Kraemer, J.; Katz, R.
International Journal of Health Policy and Management IJHPM
(2022)
CC
Health security funding is intended to improve capacities for preventing, detecting, and responding to public health emergencies. Recent years have witnessed substantial increases in the amounts of
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donor financial assistance to health security from countries, philanthropies, and other development partners. To date, no work has examined the effects of assistance on health security capacity development over time. This paper presents an analysis of the time-lagged effects of assistance for health security (AHS) on levels of capacity.
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Health systems strengthening (HSS) and health security are two pillars of universal health coverage (UHC). Investments in these areas are essential
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for meeting the Sustainable Development Goals and are of heightened relevance given the emergence of the 2019 novel coronavirus disease (COVID-19). This study aims to generate information on development assistance for health (DAH) for these areas, including how to track it and how funding levels align with country needs.
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Global health funding has increased in recent years. This has been accompanied by a proliferation in the number of global health actors and initiatives. This paper describes the state of global heat
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h finance, taking into account government and private sources of finance, and raises and discusses a number of policy issues related to global health governance. A schematic describing the different actors and three global health finance functions is used to organize the data presented, most of which are secondary data from the published literature and annual reports of relevant actors.
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Over the last few years, there has been growing attention to health systems research in fragile and conflict-affected setting (FCAS) from both researchers and donors. In 2012, an exploratory literature review was conducted to analyse the main themes
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and findings of recent literature focusing on health financing in FCAS.
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Since 2002, development assistance for health has substantially increased,
especially investments for HIV, tuberculosis (TB) and malaria control. We
undertook a systematic review to assess and synthesize the existing evidence in
the scientific li
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terature on the health impacts of these investments
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How has funding to developing countries for health improvement changed in the wake of the global financial crisis? The question is vital for policy making, planning, and advocacy purposes in donor and recipient countries alike. We measured the total
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amount of financial and in-kind assistance that flowed from both public and private channels to improve health in developing countries during the period 1990–2011
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The COVID-19 pandemic has had unprecedented public health, economic, and social impacts on the international community, and prompted an unprecedented range and size of policy actions globally. Collective efforts, at national, regional, and global le
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vels, were called for to contain and mitigate such impacts. The public health response measures alone proved to be insufficient, calling for additional socio-economic policy interventions such as ring-fencing economic activities to contain the spread of the virus. Faced with devastating socio-economic costs, all possible sources of financing, both public and private, have been explored.
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Background: At the MDG Summit in September 2010, the UN Secretary-General launched the Global Strategy for
Women’s and Children’s Health. Central within the Global Strategy are the ambitions of “more money for
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health”
and “more health for the money”. These aim to leverage more resources for health financing whilst simultaneously
generating more results from existing resources - core tenets of public expenditure management and governance.
This paper considers these ambitions from a human resources for health (HRH) perspective
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- The Facts About High Blood Pressure
- Understanding Blood Pressure Readings
- Health Threats from High Blood Pressure
- Get Down With Your Blood Pressure
- Learn How to Monitor Your Blood Pressure at Home
- Let's Talk About Blood Pressure
-
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Support That Empowers
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Health inequities are unjust and avoidable systematic differences in the health status and access to health resources of
different population grou
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ps. Health inequity manifests itself at all levels as differences across countries, within countries, between communities, and within population groups. Health inequities arise from social determinants of health, or social and
environmental conditions in which people are born, grow, live, work and age; they do not occur randomly or by chance, and are largely beyond an individual’s control.
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