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 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.
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AMR is a serious and growing global problem. A WHO report released in 2014 stated that this serious threat is no longer a prediction for the future it is happening now in every region of the world and has potential to affect anyone, of any age in any community – a real threat to the public health.... The coming together of the various important stakeholders to develop this document is the testimony of their agreement of how serious is the issue at hand and their intentions to combat AMR is translated into an Action Plan. WHO also reported that there are about 2 million people in the US are infected with the AMR organism while 23,000 die annually from AMR infections. Fiji is just 10 hours journey away from the United States of America therefore Fiji must act now to keep our population safe from AMR organisms.
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Volumen 5 / Número 1 , 1025-1028 • http://www.revistabionatura.com
To describe the behavior of Tuberculosis/Human Immunodeficiency Virus co-infection in a cohort of people affected by sensitive Tuberculosis in Ecuador from 01 January 2010 to 31 December 2015. Results: The percentage of co...infected persons reached 11% in the whole period of study, with a range from 8.4% to 12.7%. Male sex shows the highest incidence rate, representing 76.7% at the rate of 1 man for every 3.3 women. The population with the highest incidence of patients is economically active; the age group of 25-34 years reaches 40.1%. The coastal zone of the country reports more than 75% of the coinfected patients. Conclusion: Increased HIV/AIDS screening should be increased for Tuberculosis, with particular emphasis on male sex and enhance the actions in the coastal provinces.
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Alcohol use is deeply embedded in the social landscape of many societies, and some 2300 million people drink alcoholic beverages in most parts of the world. At the same time, more than half of the global population aged 15 years and older reported having abstained from drinking alcohol during the pr...evious 12 months. Several major factors have an impact on levels and patterns of alcohol consumption in populations – such as historical trends in alcohol consumption, the availability of alcohol, culture, economic status and implemented alcohol control measures. At the individual level the patterns and levels of alcohol consumption are determined by multiple factors that include gender, age and individual biological and socioeconomic vulnerability factors as well as the policy environment. Prevailing social norms that support drinking behaviour and mixed messages about the harms and benefits of drinking may encourage alcohol consumption, delay appropriate health-seeking behaviour and weaken community action.
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This document is an evidence-based policy for the implementation of sound tuberculosis (TB) infection control by all stake- holders. It recommends a combination of measures aimed at reducing the risk of TB transmission within populations. The emphasis is on early and rapid diagnosis, and proper mana...gement of TB patients.
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BMJ Open2018;8:e020423. doi:10.1136/bmjopen-2017-02042
EC has been increasingly used in the evaluation of maternal and child health programmes.12–15 For instance, Nesbitt et al compared crude coverage and EC of pregnant women with facility-based obstetric services in Ghana and estimated that alth...ough 68% of the women studied had service access only 18% received high-quality care provided by a skilled birth attendant.16 Similarly, by comparing EC of young children receiving Strengths and limitation of this study. Using multiple data sources (direct observation, vignettes, facility inventories) this study comprehensively assessed under 5-year-old child service
performance of first-line health facilities. We conducted this study in around 500 primary-level health facilities and within 7000 households
across six regions in Burkina Faso.
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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... 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. It also includes a summary of the countries health systems’ response to diabetes, including national plans, targets, surveillance, guidelines, and access to essential drugs and technologies, and synthesizes information about diabetes-related complications and the close relationship between diabetes and other pathologies, such as cardiovascular diseases, tuberculosis, and COVID-19. The data presented here reveal that, despite advances in national responses, diabetes continues to expand, and our response remains insufficient. This report aims to draw attention to the urgent need to strengthen efforts to prevent, diagnose, and control diabetes in the Region of the Americas.
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The spread of COVID-19 poses a challenge for emerging markets such as those in Africa and Latin America. While governments around the world are suffering from a shortage of ventilators, hospital beds, and personal protective equipment, availability of these items is already extremely limited in some... countries. In Africa, countries including Mali, Liberia, and Burkina Faso have only a few ventilators available to aid their populations, and there is also a lack of reliable oxygen supplies, ICUs, and healthcare workers to treat the sick. Additionally, many countries in Africa are already suffering from food insecurity and weak economies, which will worsen the long-term effects of coronavirus.
Keeping these factors in mind, GeoPoll conducted a remote study in 12 countries in sub-Saharan Africa on the effects coronavirus is already having on people throughout the region.
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World Psychiatry. 2010 Jun;9(2):67-77.
The main recommendations are presented in relation to: the need for coordinated policies, plans and programmes, the requirement to scale up services for whole populations, the importance of promoting community awareness about mental illness to increase levels ...of help-seeking, the need to establish effective financial and budgetary provisions to directly support services provided in the community. The paper concludes by setting out a series of lessons learned from the accumulated practice of community mental health care to date worldwide, with a particular focus on the social and governmental measures that are required at the national level, the key steps to take in the organization of the local mental health system, lessons learned by professionals and practitioners, and how to most effectively harness the experience of users, families, and other advocates
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his guidance provides interim guidance for the integration of SARS-CoV-2 and influenza virologic and genomic surveillance, from sentinel site case enrolment and sampling to the eventual sharing of the virus sequence data, a process known as end-to-end surveillance. This guidance builds on experience...s and lessons learned as countries adapted their influenza surveillance systems in the context of the COVID-19 pandemic and reviews new evidence to provide guidance on end-to-end surveillance. The guidance includes new algorithms and strategies to adapt sentinel systems to make them resilient and agile for addressing global and national surveillance needs for influenza and COVID-19.covid-
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DHS Further Analysis Reports No. 88 - This further analysis examines levels, trends, and determinants of neonatal mortality in Rwanda, using data from the 2000, 2005, and 2010 Rwanda Demographic and Health Surveys (RDHS).
The Bolivarian Republic of Venezuela has been facing a prolonged socio-political and economic situation that has profoundly and negatively impacted social and health indicators. The COVID-19 pandemic further aggravated the humanitarian context in the
country, which stretched the limits of an alread...y weakened national health system. Violence and social conflicts, hyperinflation, constant political tensions, the persistence of migratory movements, and intensification of climate threats and natural hazards
have worsened the living conditions and health status of populations in vulnerable situations, including women, children, and indigenous people. A large influx of returnees back to Venezuela (Bolivarian Republic of) marked the first
two years of the pandemic. However, the country’s continued deteriorating political, socio-economic, and human rights situation resulted in renewed increased migration of Venezuelans in 2022. The profile of Venezuelan migrants has progressively changed
over the years, from single men in search of better economic opportunities to families with women and children in situations of extreme vulnerability. The increasingly irregular and unsafe journeys of those migrants are constantly putting their lives at high risk
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This Rapid Gender Analysis provides preliminary information and observations on the different needs, capacities and coping strategies of Venezuelan migrant and refugee women, men, boys, and girls in Colombia. It seeks to understand how gender roles and relations have changed as a result of the crisi...s and share recommendations for how the humanitarian community can more effectively consider these changing dynamics to better meet the different needs of women, men, boys and girls of different ages, abilities and other contextually relevant forms of diversity. The refugee and migrant crisis in Colombia is characterized by gendered dynamics and has taken a significant toll on the health and welfare on all those affected, but particularly on women and girls. Refugee and migrant women and girls face profound vulnerabilities as they leave Venezuela and either cross Colombia or stay in various locations across the country; this is even more the case for those at increased risk, such as indigenous populations, adolescent girls, etc.
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Int J Health Policy Manag 2017, 6(10), 587–600
Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained to a greater extent. Previous healthcare technology management (HTM) policies in Benin ha...ve failed to produce better quality of care for the population and cost-effectiveness for the government. This study aims to identify and assess the main problems facing HTM in Benin’s public health sector, as well as the ability of key actors within the sector to address these problems.
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The aim of the people-centred framework is to help countries to develop fully prioritized and budgeted NSPs based on a culture of making full use of the available data, which are aligned with national planning cycles and which provide the basis for a robust national response that can accelerate prog...ress towards the goal of ending TB. In addition, applying the framework for other possible applications according to the country’s planning and policy cycle encourages the culture of data utilization and evidence translation into decision making and planning.
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More and more countries are completing their epidemiological mapping of trachoma in suspected
endemic districts and are preparing to distribute Zithromax® in those districts where the prevalence of
“trachomatous inflammation – follicular” (TF) is above 5% among children aged 1-9 years. Mass... drug
administration (MDA) is normally at the district level and targets the whole population with Zithromax®
tablets to those 5 years old and above; Zithromax® suspension for children between 6 months and 5
years of age; and tetracycline eye ointment 1% for infants up to 6 months old.
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In March 2020, the World Health Organization (WHO) declared that the outbreak of COVID-19, the disease caused by a new coronavirus, constituted a pandemic, given the speed and scale of its transmission. The Region of the Americas is characterized by its rich multi-ethnic and multicultural heritage. ...Nonetheless, indigenous peoples, Afro-descendants, and other ethnic groups are often subject to discrimination and exclusion, resulting in health inequities. COVID-19 may have a greater impact on certain populations, such as indigenous peoples and Afro-descendants.
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A concept (leaflet)
This document outlines the concept of a stimulus package for rabies elimination. The aim of a stimulus package is to catalyse rabies control by starting community projects, building local capacity and using success to generate momentum for growth. Governments could apply for... a package, which would provide technical and material support to run small, successful rabies control projects. These in turn build evidence for the feasibility of larger scale elimination, generate enthusiasm foaction and promote investment for sustainability and up scaling. Data reporting in return for the packages would allow the documentation of successes and lessons learnt to benefit global elimination efforts more broadly.
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HIV, viral hepatitis and STI epidemics, particularly among people who inject drugs and other key populations, continue to be fuelled by laws and policies criminalizing sex work; drug use or possession; diverse forms of gender expression and sexuality; stigma and discrimination; gender discrimination...; violence; lack of community empowerment and other violations of human rights. These sociostructural factors limit access to health services, constrain how these services are
delivered and diminish their effectiveness.
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Ade et al. BMC Health Services Research (2016) 16:5
Background: In the “Centre National Hospitalier de Pneumo-Phtisiologie” of Cotonou, Benin, little is known about
the characteristics of patients who have not attended their scheduled appointment, the results of tracing and the
possible b...enefits on improving treatment outcomes. This study aimed to determine the contribution of tracing
activities for those who missed scheduled appointments towards a successful treatment outcome.
Methods: A retrospective cohort study was carried out among all smear-positive pulmonary tuberculosis patients
treated between January and September 2013. Data on demographic and diagnostic characteristics and treatment
outcomes were accessed from tuberculosis registers and treatment cards. Information on those who missed their
scheduled appointments was collected from the tracing tuberculosis register. A univariate analysis was performed
to explore factors associated with missing a scheduled appointment
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