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The Regional Action Framework for Noncommunicable Disease Prevention and Control provides a unified vision of objectives and recommended actions to combat the noncommunicable disease (NCD) epidemic in the Western Pacific Region. Implementation should be supported by cross-sectoral coordination
...
, sustainable financing, evidence-based policy, and community engagement, tailored to each Member State’s unique context. In doing so, Member States are encouraged to transform a disease treatment-centered “sick system” into a “health system” in which a population’s health and well-being enable socioeconomic development.
more
The standards define 10 key competencies for health and care workers to support self-care in their clinical practice as well as the specific, measurable behaviours that demonstrate those competencies, focusing on people-centredness; decision-making; effective communication; collaboration; evidence-i
...
nformed practice, and personal conduct.
more
The knowledge guide is the second publication in the Self-care competency framework to support health and care workers.
This describes how health and care workers can apply each of the 10 competency standards in their work, detailing the necessary knowledge, skills and attitudes that underpin the
...
required behaviours.
more
This report started with a simple question—“How can we tell how much funding is devoted to global health programs?”—and ended (more than two years later) with an answer that is far from simple. As those who have tried know well, tracking health-related funding is challenging in any setting,
...
given the range of public and private sources and the many types of services and programs that fall within the definition of “health sector.” It is made all the more complicated when significant external support from donors and private charities plus in-kind donations of drugs and other inputs are taken into account. The task is made yet harder by inadequate public expenditure management systems in countries where public agencies’ capacity is stretched very thin and by donor accounting structures that are not designed to respond in a timely way
more
The ongoing COVID-19 pandemic has shown that public financial management (PFM) should be an integral part of the response. Effectiveness in financing the health response depends not only on the level of funding but also on the way public funds are allocated and spent, this is determined by the PFM r
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ules, and how money flows to health service providers. So far, early assessments have shown that PFM systems ranged from being a fundamental enabler to acting as a roadblock in the COVID-19 health response. While service delivery mechanisms have been extensively documented throughout the pandemic, the underlying PFM mechanisms of the response also merit attention. To highlight the importance of PFM in health emergency contexts, this rapid review analyses various country PFM experiences and identifies early lessons emerging from the financing of the health response to COVID-19. The assessment is done by stages of the budget cycle: budget allocation, budget execution, and budget oversight. Identifying lessons from the varying PFM modalities used to finance the response to COVID-19 is fundamental both for health policy-makers and for finance authorities to prepare for future health emergencies.
more
The 2018 global health financing report presents health spending data for all WHO Member States between 2000 and 2016 based on the SHA 2011 methodology. It shows a transformation trajectory for the global spending on health, with increasing domestic public funding and declining external financing. T
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his report also presents, for the first time, spending on primary health care and specific diseases and looks closely at the relationship between spending and service coverage
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This paper introduces a new dataset of official financing—including foreign aid and other forms of concessional and non-concessional state financing—from China to 138 countries between 2000 and 2014. We use these data to investigate whether and to what extent Chinese aid affects economic growth
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in recipient countries. To account for the endogeneity of aid, we employ an instrumental-variables strategy that relies on exogenous variation in the supply of Chinese aid over time resulting from changes in Chinese steel production. Variation across recipient countries results from a country’s probability of receiving aid. Controlling for year- and recipient-fixed effects that capture the levels of these variables, their interaction provides a powerful and excludable instrument. Our results show that Chinese official development assistance (ODA) boosts economic growth in recipient countries. For the average recipient country, we estimate that one additional Chinese ODA project produces a 0.7 percentage point increase in economic growth two years after the project is committed. We also benchmark the effectiveness of Chinese aid vis-á-vis the World Bank, the United States, and all members of the OECD’s Development Assistance Committee (DAC).
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We combine data on Chinese development projects with data from Demographic and Health Surveys to study the impact of Chinese aid on household welfare in sub-Saharan Africa. We use a novel methodology to test the effect of Chinese aid on three important development outcomes: education, health, and nu
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trition. For each outcome, we use difference-in-difference estimations to compare household areas near Chinese project sites to control areas located farther away, before and after receiving Chinese aid. This empirical strategy rules out many confounding factors that can bias measuring the impact of Chinese aid on our outcome variables. First, we find that Chinese projects significantly improve education and child mortality in treatment areas, but do not significantly affect nutrition. Second, social sector projects have a larger effect on outcomes than economic projects. Third, we do not find significant effects for projects that ended more than five years before the post-treatment survey wave. Our results are robust to a host of robustness checks.
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This report examines the support to private healthcare provision in India by the World Bank’s private sector arm, the International Finance Corporation (IFC). Despite supporting private healthcare in the country since 1997, no healthcare results for lending and investments have been disclosed sinc
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e the start of these operations over twenty-five years ago. The IFC has overwhelmingly invested in high-end urban hospitals which are out of reach for the majority of Indians. Several have consistently failed to provide free healthcare to poor patients despite this being a condition under which free or subsidized public land was allotted to these hospitals. Supporting private healthcare in a context where 37% of Indians experience catastrophic health expenditures in private hospitals appears to run counter to the World Bank Group’s focus on poverty reduction. These investments do not contribute to the building of stronger healthcare infrastructure or respond to unmet healthcare needs. Only 14% of IFC-financed hospitals are located in the 10 states ranked lowest in terms of the overall performance of the health system. Furthermore, we found many instances where regulators upheld complaints pertaining to violations of patients’ rights by these hospitals including overcharging, denial of healthcare, price rigging, financial conflict of interest and medical negligence.
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Background:Neonatal mortality accounts for 43% of global under-five deaths and is decreasing more slowly than maternal or child mortality. Donor funding has increased for maternal, newborn, and child health (MNCH), but no analysis to date has disaggregated aid for newborns. We evaluated if and how a
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id flows for newborn care can be tracked, examined changes in the last decade, and considered methodological implications for tracking funding for specific population groups or diseases. MethodsandFindings:We critically reviewed and categorised previous analyses of aid to specific populations, diseases, or types of activities. We then developed and refined key terms related to newborn survival in seven languages and searched titles and descriptions of donor disbursement records in the Organisation for Economic Co-operation and Development’s Creditor Reporting System database, 2002–2010. We compared results with the Countdown to 2015 database of aid for MNCH (2003–2008) and the search strategy used by the Institute for Health Metrics and Evaluation. Prior to 2005, key terms related to newborns were rare in disbursement records but their frequency increased markedly thereafter. Only two mentions were found of ‘‘stillbirth’’ and only nine references were found to ‘‘fetus’’ in any spelling variant or language
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The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will continue rising over the following years. The
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Region shows the highest number of years of healthy life lost (through either disability or premature death) due to diabetes worldwide. The high costs associated with its treatment produce a heavy economic burden. Its complications can seriously affect the quality of life of people living with diabetes, their families, and society and overload health systems. This report shows the latest internationally comparable data on diabetes and its main risk factors by year, country, and sex.
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La carga de la diabetes es enorme, posicionándola como uno de los principales desafíos que enfrenta la salud pública en la actualidad. Actualmente, se estima que 62 millones de personas viven con diabetes en la Región de las Américas y las proyecciones muestran que su prevalencia seguirá aumen
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tando en los próximos años. La Región muestra el mayor número de años de vida saludable perdidos (ya sea por discapacidad o muerte prematura) debido a la diabetes en todo el mundo. Los altos costes asociados a su tratamiento producen una pesada carga económica. Sus complicaciones pueden afectar seriamente la calidad de vida de las personas que viven con diabetes, sus familias y la sociedad y sobrecargar los sistemas de salud. Este informe muestra los últimos datos comparables internacionalmente sobre la diabetes y sus principales factores de riesgo por año, país y sexo. También incluye un resumen de la respuesta de los sistemas de salud de los países a la diabetes, incluidos planes nacionales, objetivos, vigilancia, directrices y acceso a medicamentos y tecnologías esenciales, y sintetiza información sobre las complicaciones relacionadas con la diabetes y la estrecha relación entre la diabetes y otras patologías, como enfermedades cardiovasculares, tuberculosis y COVID-19.
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WHO/Europe has launched a new guide, providing support to countries on how to apply behavioural and cultural insights (BCI) for health. It presents a simple step-wise approach, complemented by a rich collection of detailed considerations, tools and exercises. The guide is the first of its kind, spec
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ifically developed for use by public health professionals developing policies, services and communications informed by BCI across health topics.
Some of the most persistent public health challenges involve human behaviour. Using a BCI lens means that health policies, services and communications can be tailored to the needs and circumstances of people and communities, and thereby help combat these challenges. The new Tailoring Health Programmes (THP) guide describes how this can be done.
Building on several topic-specific guides that focused on applying BCI to routine and influenza vaccination and tackling antimicrobial resistance, as well as external evaluations and a rigorous peer-review process, this guide is the result of over a decade of work by WHO/Europe. The THP approach has already been adopted in over 20 countries and has received positive feedback from public health agencies.
“This guide is the culmination of a decade of work involving many colleagues at country, regional and global levels. The guide is our “BCI bible”, guiding our work with and in countries to help tackle persistent health challenges,” said Katrine Bach Habersaat, Regional Advisor for BCI at WHO/Europe.
Karina Godoy, Senior Analyst and National Focal Point for Behavioural Insights at the Public Health Agency of Sweden, who is employing the approach described in the guide across several health projects, comments: “The THP guide is easy to use and at the same time provides detailed guidance and inspiration where needed. We have decided to translate the document into Swedish and use the approach widely”.
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In 2015 around 15 million people living with HIV were receiving antiretroviral treatment (ART) in sub–Saharan Africa. Sustained provision of ART, though both prudent and necessary, creates substantial long–term fiscal obligations for countries affected by HIV/ AIDS. As donor assistance for healt
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h remains constrained, novel financing mechanisms are needed to augment funding domestic sources. We explore how Innovative Financing has been used to co–finance domestic HIV/AIDS responses. Based on analysis of non–health sectors, we identify innovative financing instruments that could be used in the HIV response.
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This document lays out economic arguments for investing in the Access to COVID-19 Tools Accelerator (ACT-Accelerator). Framed within an overall context that recognizes the broader human health and societal impacts of the COVID-19 crisis, ACT-Accelerator's Economic Investment Case argues that investm
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ent in ACT-Accelerator is the world’s best bet and most viable solution for restarting the global economy. It is intended for governments, multilaterals, civil society, businesses and foundations and all those interested in the work required to change the course of the pandemic. The global deployment of ACT-Accelerator’s comprehensive package of tools will reduce the severity of COVID-19 disease, enabling countries to transition out of the crisis thereby restarting domestic and international economic engines driving our global economy.
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This paper explores the angles and opportunities of digital health, with a look
at digital innovation and its potential to support patients with circulatory diseases.
In reviewing developments in the field, current applications as well as gaps, the paper aims to support policymakers in leveraging
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technology for better circulatory health and to capture the roles that various sectors have in making
digital health a tool for everyone.
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ABSTRACT
More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service del
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ivery.
Digital health technologies can help address these challenges. They may be a tool
to reach Sustainable Development Goal 3.4 and reduce premature mortality from
non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation.
World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.
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In 2012, all Member States of the World Health Organization (WHO) endorsed a historical target to reduce premature mortality from noncommunicable diseases
(NCD). This commitment was echoed in 2015 by the United Nations Sustainable Development Goals, which included a target to reduce premature morta
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lity (the
measure of unfulfilled life expectancy and deaths between the ages of 30 and 70 years) from NCD by 30% by the year 2030. The Sustainable Development Goals are especially relevant to cardiovascular disease (CVD), the leading cause of death globally, with increasing prevalence in low- and middle-income countries (LMIC).
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The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the principal cardiovascular diseases leading to death
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and disability. Atrial fibrillation (AF) is one of these conditions and is an increasing problem due to ageing of the world’s population and an increase in cardiovascular risk factors that predispose to AF. The goal of the AF roadmap was to provide guidance on priority interventions that are feasible in multiple countries, and to identify roadblocks and potential strategies to overcome them.
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Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co
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untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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