The objective of the Nairobi Metropolitan Services Improvement Project for Kenya is to strengthen governance and service delivery in the Nairobi Metropolitan area.
... See More + Negative impacts include: air quality, dust, noise pollution, water quality, dust, soil erosion, flora and fauna, and waste management. Mitigation measures include: develop soil erosion control measures which should include silt management structures; proper drainage system to be constructed within town; limit the circulation of heavy machinery to minimal areas to reduce soil compaction and vegetation clearance; locate access roads perpendicularly or diagonally to the slope rather than along steep slopes; obtain water abstraction permit and use metering methods to ensure water is abstracted to recommended limit; do not dispose any form of waste in water bodies; keep natural water channels free from obstruction; consult with community members when identifying water sources to avoid conflicts and abstract water according to conditions of acquired permits taking into consideration the quantified reserve for the water body in question; all trees uprooted to pave way for road expansion and access construction should be replanted with indigenous trees; operate equipment with air pollution control and environmental management systems; insulate noisy machines when working near residential area; maintain vehicles and machinery in good condition in order to minimize gas emissions and noise; contractor in collaboration with proponent should develop Corporate Social Responsibility Program (CSRP); and contractor should hold continuous site meetings with workers and community members.
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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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While on-track for child health and maternal health MDGs, Lao PDR continues to have some of the worst maternal and child health (MCH) outcomes, both globally and in the East Asia and Pacific (EAP) region.
... See More + Under-five and infant mortality rates are high relative to GDP per capita, and utilization of essential health services is low, given significant demand-side barriers including physical access, cultural, and financial barriers. Furthermore, about a third of all children under-five remain underweight and almost half are stunted. Lao PDR is hence off-track on the nutrition-related MDG. In addition to poor aggregate measures, there are significant economic, urban rural, geographic, and ethnic group-related inequalities in health and nutrition outcomes. This policy note provides a snapshot of human resources for health (HRH) in health centers in the Lao People’s Democratic Republic (Lao PDR) based on an analysis of a health facility survey (the UFGE-CNP health center survey) that collected information from a nationally-representative sample of 120 public health centers (HCs) from 2013 to 2014. This survey was conducted as a baseline for health sector reform plans, to inform policymaking as Lao PDR scales-up programs to attain health-related MDGs, expand basic health services, and attain universal health coverage (UHC). This note complements a related health financing note which includes health center financing data from the same survey. Key findings from that note include low government health spending, associated with a high reliance on out-of-pocket (OOP) spending and external financing, which translates to underfunding of HCs (especially non-wage recurrent expenditure) and dependence on OOP revenue from revolving drug funds (RDFs).
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Discrete choice experiments (DCEs) are attribute-driven experimental techniques used to elicit stakeholders’ preferences to support the design and implementation of policy interventions.
... See More + The validity of a DCE, therefore, depends on the appropriate specification of the attributes and their levels. There have been recent calls for greater rigor in implementing and reporting on the processes of developing attributes and attribute-levels for discrete choice experiments (DCEs). This paper responds to such calls by carefully reporting a systematic process of developing micro health insurance attributes and attribute-levels for the design of a DCE in rural Malawi. Conceptual attributes and attribute-levels were initially derived from a literature review which informed the design of qualitative data collection tools to identify context specific attributes and attribute-levels. Qualitative data was collected in August-September 2012 from 12 focus group discussions with community residents and 8 in-depth interviews with health workers. First, a consensus, emerging from an individual level analysis of the qualitative transcripts, identified 10 candidate attributes. Levels were assigned to all attributes based on data from transcripts and knowledge of the Malawian context, derived from literature. Second, through further discussions with experts, four attributes were discarded based on multiple criteria. The 6 remaining attributes were: premium level, unit of enrollment, management structure, health service benefit package, transportation coverage and copayment levels. A final step of revision and piloting confirmed that the retained attributes satisfied the credibility criteria of DCE attributes. This detailed description makes our attribute development process transparent, and provides the reader with a basis to assess the rigor of this stage of constructing the DCE. This paper contributes empirical evidence to the limited methodological literature on attributes and levels development for DCE, thereby providing further empirical guidance on the matter, specifically within rural communities of low- and middle-income countries.
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Many Governments wrestle with the issue of designing an appropriate set of human resource practices to motivate public servants to perform. Identifying the right set of practices for the public sector is a source of some controversy, and passions run high particularly in relation to the use of monetary incentives, often referred to as performance-related pay or performance based pay.
... See More + This GET note reviews recent research on a range of practices Governments utilize to drive employee performance, which rest on the assumptions that public servants are motivated in two ways: (i) ‘intrinsically’ (i.e. internal factors motivated by ‘the right thing to do’), and (ii) ‘extrinsically’ (i.e., external validation from rewards offered by others). Generally, a Human Resource Management (HRM) system designed to motivate employee performance will utilize practices in two broad categories related to: (i) ‘external incentives’ (e.g., financial incentives), and (ii) ‘opportunities to perform’ focusing on ‘intrinsic’ factors (i.e. self-directed work). Within ‘external incentives,’ a financial incentive may either act over the long term (e.g., deferred compensation) or in the short term (e.g., performance-related pay). This note applies this conceptual framework to more clearly understand the range of practices Governments are using to improve staff performance, as well as the pre-conditions for their success. Given the recent attention on performance-related pay, we take a deeper look at the evidence underlying the shorter term performance-related pay, reviewing evidence from both OECD and middle income countries. Annex one provides a brief overview on the theories of motivation for those interested in the theoretical underpinnings of the work, and annex two presents’ experiences of performance pay in practice. This Note draws heavily from performance-related pay in the public sector: A review of theory and evidence (Hasnain and others 2012), a recent review of the literature in fields including political science, public administration, business management, and psychology.
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Egypt, the most populous country in the Arab world, has a well-respected system of medical education, but has difficulty delivering high-quality medical care because of inadequate hospital facilities.
... See More + To tackle the problem, the government of Egypt sought IFC’s assistance in the country’s first public-private partnerships in the health sector to design, build and operate two new specialty teaching hospitals. These will be located at Alexandria University, a leader among Egypt’s educational and healthcare institutions. The concessions were signed on April 30, 2012, and are expected to be ready to receive patients in 2014. An international consortium led by Bareeq Capital, an Egyptian private equity firm focusing on social infrastructure projects, together with local and international partners, G4S, Siemens and Detac, won the 20-year concession contracts for two new hospitals in Alexandria, Egypt’s second largest city. Smouha Maternity University Hospital is planned as a 200-bed gynecology and obstetrics center with a blood bank facility, while the Mowassat Specialized University Hospital will be a 224-bed facility providing neurosurgery, urology and nephrology services. Both hospitals will serve the current and future needs of the expected patient population, as well as provide a strong foundation for the clinical teaching component of Alexandria University.
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Guidance Note 4 corresponds to Performance Standard 4. Performance Standard 4 recognizes that project activities, equipment, and infrastructure can increase community exposure to risks and impacts.
... See More + In addition, communities that are already subjected to impacts from climate change may also experience an acceleration and/or intensification of impacts due to project activities. While acknowledging the public authorities’ role in promoting the health, safety, and security of the public, this Performance Standard addresses the client’s responsibility to avoid or minimize the risks and impacts to community health, safety, and security that may arise from project related-activities, with particular attention to vulnerable groups. In conflict and post-conflict areas, the level of risks and impacts described in this Performance Standard may be greater. The risks that a project could exacerbate an already sensitive local situation and stress scarce local resources should not be overlooked as it may lead to further conflict.
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