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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort
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into specific activities, and by increasing the amount of resources available to finance the delivery of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
more
Improving the survival chances and quality of life of women, newborns, and children remains an urgent global challenge. Since 2012, substantial progress
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has been made in reducing maternal and under-5 deaths, and a only handful of countries are on target to meet the SDG targets in 2030. Yet, 5 million children still die each year under the age of 5, and nearly half of those are newborns less than a month old. Worse still, the global maternal mortality ratio is going in the wrong direction.
A Decade of Progress and Action for the Future will examine the tenacity and innovation that helped us make gains, the lessons learned through monitoring, country-led adaptation and leadership, analysis, and reflection, as well as the approaches we must take to reinvigorate the momentum and global commitment to improving maternal and child survival. Increasing coverage, strengthening the quality of care, and enhancing equity will be tantamount to our global progress.
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Available in English, French and Spanish
Nepal has made substantial progress in reducing under-five mortality and is on track to achieve Millennium Development Goal 4, but advances in neonatal health are less encouraging. The objectives of
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this study were to assess relative and absolute inequalities in neonatal mortality over time, and to review experience with major programs to promote neonatal health.
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This status report shows how far we have come—and how much further we must go—if we hope to meet the global commitments to end AIDS in children. It offers a snapshot of global progress
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and permits an early assessment of the impact of the Global Alliance’s work.
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The government of Rwanda conducted the 2010 Rwanda Demographic and Health Survey (RDHS) to gather up-to-date information for monitoring progress on healthcare programs
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and policies in Rwanda, including the Economic Development and Poverty Reduction Strategy (EDPRS), the Millennium Development Goals (MDGs),
and Vision 2020. The 2010 RDHS is a follow-up to the 1992, 2000, 2005, and 2007-08 RDHS surveys. Each survey provides data on background characteristics of the respondents, demographic and health indicators, household health expenditures, and domestic violence. The target groups in these surveys were women age 15-49 and men age 15-59
who were randomly selected from households across the country. Information about children age 5 and under also was collected, including the weight and height of the children.
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This report provides a comprehensive overview of the progress made by India in terms of establishment and functionality of Special Newborn Care Units (SNCUs) during the two year period from April 20
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13 to March 2015. It describes the progress in the operational status (numbers, bed strength, human resource availability), the profile of babies admitted in these units and of those babies who died during stay. In addition it provides individual state specific statistics to facilitate differential planning and better monitoring of these units in India.
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As countries aim to progress towards the Sustainable Development Goals (SDGs) and achieving universal health coverage, health inequities driven by racial discrimination
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and intersecting factors remain pervasive. Inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities are of concern globally; they are unjust, preventable and remediable.
Health systems themselves are important determinants of health and health equity. They can perpetuate health inequities by reflecting structural racism and discriminatory practices of wider society. For instance, systemic racism, implicit bias, misinformed clinical practice, or discrimination by health professionals contributes to health inequities. However, health systems can also be a leading force for tackling the inequities faced by populations experiencing racial discrimination.
Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
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This document by Medicines for Malaria Venture (MMV) highlights the significant burden of malaria on children worldwide, emphasizing the need for effective prevention, diagnosis, and treatment strategies. It reviews current challenges
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and progress in combating pediatric malaria, advocating for continued research and investment to reduce malaria-related morbidity and mortality in children, especially in high-burden regions.
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Policy Research Working Paper 6100 | Impact Evaluation Series No. 60 | This study examines the effect of performance incentives for health care providers to provide more and higher quality care in R
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wanda on child health outcomes. The authors find that the incentives had a large and significant effect on the weight-for-age of children 0–11 months and on the height-for-age of children 24–49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill .
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A companion to the Child Friendly Schools Manual
WASH in Schools aims to improve the health and learning performance of school-aged children – ... and, by extension, that of their families – by reducing the incidence of water and sanitation-related diseases. Every child friendly school requires appropriate WASH initiatives that keep the school environment clean and free of smells and inhibit the transmission of harmful bacteria, viruses and parasites. more
WASH in Schools aims to improve the health and learning performance of school-aged children – ... and, by extension, that of their families – by reducing the incidence of water and sanitation-related diseases. Every child friendly school requires appropriate WASH initiatives that keep the school environment clean and free of smells and inhibit the transmission of harmful bacteria, viruses and parasites. more
14 January 2021
This practical guide can be used to help countries monitor and analyse the impact of COVID-19 on essential health services to inform planning and decision-making. It provides practi
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cal recommendations on how to use key performance indicators to analyse changes in access to and delivery of essential health services within the context of the COVID-19 pandemic; how to visualize and interpret these data; and how to use the findings to guide modifications for safe delivery of services and transitioning towards restoration and recovery. The guide focuses on existing indicators and data that are captured in routine reporting systems and how they can be used by national and subnational authorities to understand specific contexts, challenges and bottlenecks. This guide supports Maintaining essential health services: operational guidance for the COVID-19 context, which provides an integrated framework to guide countries in their efforts to reorganize, adapt and maintain safe delivery of high-priority essential health services within the context of the pandemic.
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This fourth WHO report on neglected tropical diseases (NTDs) reviews the progress made towards achieving the Roadmap targets for 2020, noting the remaining challenges, then looks beyond 2020 to evaluate the changing global health
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and development landscape, considering the implications of integrating these diseases into the broader 2030 Agenda for Sustainable Development.
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Sound periodic programme reviews provide opportunities for countries to objectively assess progress and take corrective action to sustain or get back on track towards achieving their medium
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and long-term programme goals. It reflects people’s diverse needs, enables efficient use of health system resources and improves the predictability, sustainability and transparency of the programmes.
This publication provides guidance to countries on how to perform programme reviews for HIV, viral hepatitis and sexually transmitted infections in this dynamic health sector context. The guidance encourages integrated reviews across health programmes for more efficient use of health system resources. The welfare of populations to be served must be at the centre of health programme reviews, with the overarching resolve to protect and promote health as a human right.
This guidance is intended for use by all national partners, including health ministries, related ministries, civil society, affected communities and other stakeholders, for participatory and evidence-informed programme reviews.
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13 May 2021
To avoid a reversal of progress from the adverse impacts of the COVID-19 pandemic, new knowledge and lessons from successful programmatic innovations are urgently needed to improve TB p
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revention and care. Experience can provide evidence for innovative approaches and strategies to maintain and scale up high-quality TB services. WHO therefore called for case studies on programmatic innovations that address emerging challenges in TB prevention and care during the pandemic in order to collect and disseminate the findings to the TB community. Between November 2020 and February 2021, a total of 23 case studies relevant to the call were accepted from 19 countries in the six regions of WHO. The lessons learnt from these country activities to ensure the continuity of essential services like TB care in the face of the crippling crisis may also inform strategies for minimizing the impact of future emerging pathogens on health services.
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Communicable and non-communicable diseases in Africa in 2021/22
World Health Organization Africa Region; WHO Africa
World Health Organization Africa Region; WHO Africa
(2023)
C_WHO
This report is one of the first major products of the newly established Precision Public Health Metrics unit of the UCN cluster of the WHO Regional Office for Africa. The report presents national trends in communicable and non-communicable disease b
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urden and control in the WHO African region. It tracks progress made with respect to disease burden reduction, elimination and eradication. It also highlights major emerging threats, opportunities and priorities in the fight against commu- nicable and non-communicable diseases in the region. It covers the period 2000-2022, but for some indicators, information is available only up to 2021.
The report shows the number of reported cases for malaria and vaccine preventable diseases (meningitis, measles, yellow fever, pertussis, diphtheria, tetanus, and polio); disease incidence due to HIV, tuberculosis and four major noncommunicable diseases (cardiovas- cular diseases, cancers, diabetes and chronic respira- tory diseases).
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To support the achievement of health equity in the Region, the regional inter-agency movement Every Woman Every Child Latin America and the Caribbean (EWEC-LAC) advocates for and supports the use of
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equity and evidence-based policies, strategies and interventions to accelerate equitable progress in the health of women, children and adolescents. Although progress has been made, great inequities persist. Women from the LAC region’s poorest countries are almost four times more likely to die due to complications during childbirth than those living in the wealthiest countries. Through the years, several tools, instruments and methods (TIMs) have been developed by global, regional and country partners that can be used to conduct systematic equity-based analyses and/or re-designs of health systems, programs, strategies and interventions. The main purpose of this document is to present an overview of existing TIMs that can be used by policymakers, program managers, development partners, nongovernmental organizations, academia and civil society partners to strengthen systematic identification, analysis and responding to social inequities in the health of women, children and adolescents in LAC. The TIMs included were identified through a systematic search process
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A wide range of potential enablers and barriers were identified for influencing progress for the scale-up of severe wasting services within national health systems. Findings were categorised accordi
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ng to the six pillars of WHO’s health system strengthening framework.
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The COVID-19 Strategic Preparedness and Response Plan (SPRP) 2021 Monitoring and Evaluation Framework tracks global progress against the COVID-19 S
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PRP 2021 for the ten pillars of the public health response. The operational intelligence complements the epidemiologic information used to drive a global dynamic system of support and response. Monitoring SPRP 2021 implementation will support countries, partners and WHO in strategic thinking, operational tracking and course correction based on evidence and transparency to strengthen the response to COVID-19.
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The Food and Agriculture Organization of the United Nations (FAO) launched a new Framework for Environmental and Social Management (FESM) to ensure that both people
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and the environment are protected from any potential impacts of FAO programmes and projects.
“This Framework ensures that our projects do both “no harm” and support the transformation to more efficient, more inclusive, more resilient and more sustainable agrifood systems by upholding the highest international standards for risk management,” FAO Director-General QU Dongyu explained during a virtual event.
The Framework, which includes key elements of a people-centered approach and establishes environmental and social performance requirements for FAO programming, is also intended to ensure that all stakeholders, including local and indigenous communities, have ample opportunities to actively participate in projects’ activities and to voice their concerns about them.
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