The development objective of the Health System Support Project for Mauritania is to improve utilization and quality of reproductive maternal neonatal and child health (RMNCH) services in selected regions, and, in the event of an eligible crisis or emergency, to provide immediate and effective response to said eligible crisis or emergency.
... See More + The project comprises of four components. The first component, support to improving utilization of quality RMNCH services through performance-based financing (PBF) consists of following sub-components: (i) provision of PBF payments to health service providers; and (ii) verification and counter-verification. The second component, support to increasing demand for health services will support activities on the demand-side to promote and facilitate access to health services, especially for the poorest. It consists of following sub-components: (i) conditional cash transfers to stimulate demand for health care; and (ii) strengthening of community health. The third component, capacity building and project management will finance project management and comprehensive capacity-building activities, including substantial technical assistance. The fourth component, contingency emergency response (CERC) will be included under the project in accordance with operational policy (OP) 10.00 paragraphs 12 and 13, for projects in situations of urgent need of assistance or capacity constraints. This will allow for rapid reallocation of project proceeds in the event of a natural or man-made disaster or crisis that has caused, or is likely to imminently cause, a major adverse economic and or social impact.
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The report estimates the costs, impacts and financing scenarios to achieve the World Health Assembly global nutrition targets for stunting, anemia in women, exclusive breastfeeding and the scaling up of the treatment of severe wasting among young children.
... See More + To reach these four targets, the world needs $70 billion over 10 years to invest in high-impact nutrition-specific interventions. This investment would have enormous benefits: 65 million cases of stunting and 265 million cases of anemia in women would be prevented in 2025 as compared with the 2015 baseline. In addition, at least 91 million more children would be treated for severe wasting and 105 million additional babies would be exclusively breastfed during the first six months of life over 10 years. Altogether, achieving these targets would avert at least 3.7 million child deaths. Every dollar invested in this package of interventions would yield between $4 and $35 in economic returns, making investing in early nutrition one of the best value-for-money development actions. Although some of the targets—especially those for reducing stunting in children and anemia in women—are ambitious and will require concerted efforts in financing, scale-up, and sustained commitment, recent experience from several countries suggests that meeting these targets is feasible. These investments in the critical 1000 day window of early childhood are inalienable and portable and will pay lifelong dividends – not only for children directly affected but also for us all in the form of more robust societies – that will drive future economies.
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Publication 114429 APR 20, 2017
Shekar,Meera; Kakietek,Jakub Jan; Dayton,Julia M.; Walter,DylanFrenchDisclosed
Global Health Investment Fund (GHIF) is a novel social impact fund established to finance the development of drugs, vaccines, and diagnostic tests for diseases that disproportionately burden low and middle income countries.
... See More + As of December 2016, GHIF had invested in seven companies for development and manufacture of treatments for diseases such as cholera and river blindness, as well as diagnostic tests for tuberculosis, HIV, malaria, dengue, preeclampsia and gestational diabetes. GHIF’s most recent investment is financing further development of Tribendimidine, a drug to combat soil-transmitted helminth infections. These parasitic worms are among the most common infections found in poor communities, and affect nearly 900 million children worldwide. More broadly, GHIF’s investments are helping to end a global shortage of cholera vaccines and enabling cheaper, more effective diagnostic tests for HIV and malaria, providing more accurate results and reducing healthcare costs. GHIF is demonstrating that it is possible to have social impact and it expects to generate reasonable financial returns for investors. The keys to its success are the investor guarantee mechanism, affordable pricing, and partnerships. In the future, GHIF wants to scale and expand the model. In a year or two, it will review the portfolio and identify which interventions were most cost effective, as measured by lives saved per dollar, and the impact on its double bottom line. It anticipates raising capital for a successor fund. In addition, it plans to optimize areas that have proved successful. Given the enormous needs, GHIF expects that it will continue to focus on drugs, vaccines, and diagnostics for neglected diseases in emerging markets.
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This Program for results (PforR) will support a subset of the Nepal Health Sector Strategy (NHSS -2015- 2020) which outlines the government of Nepal’s (GoN) program towards achieving its goal of Universal Health Coverage (UHC).
... See More + The government’s reform program recognizes that improved health outcomes hinge on the ability of the Ministry of Health (MoH) to direct public resources to areas of need, and to react to and make evidence-based decisions. The PforR focuses on those outcomes and sub-outcomes of NHSS which aim to strengthen supply and demand side constraints of institutional performance to support more efficient use of resources for targeted and better service delivery over time. The PforR recognizes that establishing rigorous institutional systems and sound accountability mechanisms requires long-term changes in process and institutional culture. Therefore it focuses on improving the capacity of the MoH to manage public procurement and establishing mechanisms for logistics management and quality assurance. At the same time the Program also supports better planning and targeting through strengthening data availability and analysis. Demand side accountability mechanisms will be strengthened to integrate citizen engagement into the process of public governance. The PforR focuses on improving health service delivery and strengthening fiduciary systems and as such is not expected to have adverse environmental impacts. However, the Program provides an opportunity to strengthen and mainstream environmental and social issues within the systems strengthening objective of the PforR which will further support its overarching objective of improving health service delivery and accessibility. This opportunity is recognized by the GoN which has expressed interest and commitment to address the main environmental and social risks associated with the health sector service delivery in Nepal.
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South Asia Region (SAR) has decreased maternal mortality ratio (MMR) by 65 percent between 1990 and 2013, which was the greatest progress among all world regions.
... See More + Such achievement implores the question, What made SAR stand out against what is predicted by standard socioeconomic outcomes?Improving Maternal and Reproductive Health in South Asia: Drivers and Enablers identifies the interventions and factors that contributed to reducing MMR and improving maternal and reproductive health (MRH) outcomes in SAR. In this study, the analytical framework assumes that improving MRH outcomes is influenced by a multitude of forces from within and outside the health system and considers factors at the household and community levels, as well as interventions in other sectors and factors in the enabling environment. The analysis is based on a structured literature review of the interventions in SAR countries, relevant international experience, and review of the best available evidence from systematic reviews. The focus of the analysis is mainly on assessing the effectiveness of interventions. The findings from this study indicate that the most effective interventions that prevent maternal mortality are those that address the intra-partum stage - the point where most maternal deaths occur - and include improving skilled birth attendance coverage, increasing institutional delivery rates, and scaling up access to emergency obstetric care. There is also adequate evidence that investing in family planning to increase contraceptive use also played a key role during the inter-partum phase by preventing unwanted pregnancies and thus averting the risk of maternal mortality in SAR countries. Outside the programmatic interventions, the levels of household income, women’s education, and completion of secondary education of girls were also strongly correlated with improved MRH outcomes. Also, there is strong evidence that health financing schemes - both demand and supply side - and conditional cash transfer programs were effective in increasing the uptake of MRH services. The study points out to many other interventions with different degrees of effectiveness. The study also identified four major reasons for why SAR achieved this progress in MMR reduction.The best practices and evidence of what works synthesized in this study provide an important way forward for low- and middle-income countries toward achieving the health-related Sustainable Development Goals.
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This report assesses Indonesia’s health financing system. As an intrinsic and necessary element of universal health coverage (UHC), health financing is not only about assessing the sufficiency of resources, but also about how equitably and efficiently resources are raised, pooled, and allocated to make progress towards UHC.
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Strong economic growth in recent years has helped reduce poverty to 43 percent of the population. Yet, as Africa’s population expands, it is estimated to reach 2.5 billion by 2050, the region faces a critical challenge of creating the foundations for long-term inclusive growth.
... See More + Many countries still contend with high levels of child and maternal mortality, malnutrition is far too common, and most health systems are not able to deal effectively with epidemics and the growing burden of chronic diseases, such as diabetes. These challenges call for renewed commitments and accelerated progress toward Universal Health Coverage (UHC), the principle that everyone receives needed health services without financial hardship. The primary reason for investing in UHC is a moral one: it is not acceptable that some members of society should face death, disability, ill health or impoverishment for reasons that could be addressed at limited cost. However, UHC is also a good investment. Prevention of malnutrition and ill health is likely to have enormous benefits in terms of longer and more productive lives, higher earnings, and averted care costs. Effectively meeting demand for family planning will accelerate the fertility transition, which in turn will result in higher rates of economic growth and more rapid poverty reduction. And strong health and disease surveillance systems halt epidemics that take lives and disrupt economies. In 2015, the forgone economic growth due to Ebola amounts to more than a billion US dollars in the three countries hit by the epidemic.
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Ratings for the Second Phase of the Health Reform Program Project for Peru were as follows: outcomes were moderately satisfactory, the risk to development outcome was moderate, the Bank performance was moderately satisfactory, and the Borrower performance was also moderately satisfactory.
... See More + Some lessons learned included: the importance of culturally-sensitive interventions to ensure effective access of indigenous populations to health services (e.g. vertical delivery and casas de espera); this requires action on the demand as well as on the supply side, since both families and healthcare professionals need to understand their respective roles and perceptions. The crucial role of M&E systems to monitor project performance and to ensure correction measures can be taken in a timely fashion and at the appropriate level; particularly, being able to recognize and address the weaknesses of M&E design early on and having a strong and meaningful RF from the start, which can be revised as needed to reflect the project’s success and implementation pace. The RF should reflect appropriate baseline and targets, identify indicators for outcomes and outputs directly attributable to the project and those to which the project only contributes, and present a clear results chain of PDO, outputs and project activities. The difficult balance between the importance of maintaining ongoing dialogue and long-term engagement with a country, on the one hand, and the efficiency in the use of scares resources when pursuing relatively small investments in projects that require substantial levels of supervisions and high volumes of transactions, on the other. In this project, supervision efforts to oversee all program’s transactions were disproportionate compared to the size of the loan, which accounted for less than 10 percent of the program resources. As many countries transition from low-middle income to higher income levels, this questions becomes more and more relevant for Bank operations.
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Implementation Completion and Results Report ICR3691 JUN 30, 2016
This policy note provides an overview of government health financing in the Lao People’s Democratic Republic (PDR), with an added focus on health center financing.
... See More + The note summarizes overall trends in health outcomes and government health financing over 2000-2014 and analyzes trends in planned and realized government budgetary health spending data covering fiscal years (FYs) 2000/01 to 2013/14 and planned expenditures for FYs 2014/15, updating a previous assessment conducted in 2012.1 In addition, this note summarizes findings from health center financing data collected as part of the UFGE-CNP facility survey which collected information from a nationally-representative sample of 120 health centers in 2013-14. This policy note is one of a series designed to disseminate findings of the World Bank’s program of analytic and advisory activities for health in Lao PDR.
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Tuberculosis (TB) is a significant problem within the Southern African mining industry. In South Africa alone, TB rates within the mining workforce are estimated at 2,500-3,000 cases per 100,000 individuals.
... See More + Of the estimated 500,000 mineworkers in South Africa’s mines, approximately 40 percent originate from Mozambique, Swaziland, and Lesotho. Factors that contribute to the high incidence of TB among mineworkers include prolonged exposure to silica dust, poor living conditions, high HIV prevalence in mining communities, poverty, and a poor cross border health referral system. National associations representing current and former mineworkers in South Africa, Lesotho, Mozambique, and Swaziland have played a critical role in raising awareness amongst their members and mining communities about the risk factors for and impact of TB infection. This case study summarizes how current and former mineworkers in Southern Africa- through their membership organizations- have successfully engaged key policy and decision makers at both national and regional levels and have advocated for the inclusion of their voice, perspective, and needs in the development of TB policies and practices.
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This study analyzes the national and inter-provincial burden of disease, the demographics of new HIV cases, the demand and supply-sides of service delivery, and conducts a cost-benefit analysis of the National HIV/AIDS Program over the last decade.
... See More + Though the National HIV/AIDS Program was an instrumental step towards these achievements, this book also examines other key programmatic innovations that have been essential to the country's success in the fight against HIV/AIDS, including the introduction of universal free antiretroviral treatment; a comprehensive legal framework for sexual and reproductive rights; the introduction of incentives and results-based financing in the HIV/AIDS program; electronic monitoring of supplies and medicines; and implementation of an electronic clinical governance system for improving the quality of care and patient follow-up, among others. Despite high costs of the Program, this study found the Argentine National HIV/AIDS Program is cost-beneficial. From 2000 to 2010, 4,379 potential lives were saved. Nonetheless, the fight against this epidemic poses continuous challenges, including a stubbornly high number of new infections among young men who have sex with men, inequalities in HIV/AIDS rates between provinces, insufficient coverage of HIV diagnostic testing, insufficient HIV testing of tuberculosis patients, low expenditure on HIV prevention, high comparative cost of antiretroviral treatment, and questions regarding the long-term financial sustainability of the AIDS program, considering the increasing number of patients in treatment.
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This country case study is part of a larger impact evaluation effort that reviews investment climate (IC) reform programs implemented by the World Bank Group (WBG) in Burkina Faso, Liberia, Rwanda, Sierra Leone and South Sudan.
... See More + This follows a study carried out in 2011 across the same countries. The purpose of the evaluation is to update, expand, and deepen the initial analysis within the framework of the earlier study, in order to gain a better understanding of the impact and sustainability of the IC reform activities implemented by the WBG.
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IFC’s sustainability framework articulates the Corporation’s strategic commitment to sustainable development, and is an integral part of IFC’s approach to risk management.
... See More + The Sustainability Framework comprises IFC’s Policy and Performance Standards on Environmental and Social Sustainability, and IFC’s Access to Information Policy. The Policy on Environmental and Social Sustainability describes IFC’s commitments, roles, and responsibilities related to environmental and social sustainability. IFC’s Access to Information Policy reflects IFC’s commitment to transparency and good governance on its operations, and outlines the Corporation’s institutional disclosure obligations regarding its investment and advisory services. The Performance Standards are directed towards clients, providing guidance on how to identify risks and impacts, and are designed to help avoid, mitigate, and manage risks and impacts as a way of doing business in a sustainable way, including stakeholder engagement and disclosure obligations of the client in relation to project-level activities. In the case of its direct investments (including project and corporate finance provided through financial intermediaries), IFC requires its clients to apply the Performance Standards to manage environmental and social risks and impacts so that development opportunities are enhanced. IFC uses the sustainability framework along with other strategies, policies, and initiatives to direct the business activities of the Corporation in order to achieve its overall development objectives. The performance standards may also be applied by other financial institutions.
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