There is general recognition across stakeholders in Armenia that the e-health system can facilitate exchange of clinical and non-clinical information, transparency and accountability in service provision, and support for monitoring and evaluation.
... See More + By tracking patient movement across health facilities, the e-health system links budgetary allocations to service use, enabling efficiency and supporting performance-based financing. However, scale-up of the e-health system has presented financial, technical, and organizational challenges that have negative implications for the sustainability of the system, efficient health care delivery, and the system’s ability to meet informational requirements for health decision-making. There are opportunities to iteratively adapt the e-health system in Armenia through a systematic assessment of the e-health system scale-up experience and through regular and structured interactions between the private operator of the e-health system, key stakeholders involved in the implementation of the e-health system, and policy makers that can facilitate the adoption of needed changes. The Armenian experience of implementing an integrated health information system provides useful lessons for improving the functionality of the current system and for adopting technologies to improve health systems more generally. To encourage facilities to continue to use the e-health system, there is an immediate need for financial support for the associated recurrent costs for maintaining the e-health system and technical assistance, including training and user manuals, to guide everyday use by medical practitioners.
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In Nigeria, health care is devolved to the states and primary health care (PHC) is the responsibility of the local governments, but existing budget and capacity constraints impact delivery for an effective health program.
... See More + To respond to this concern, the Federal Ministry of Health (FMOH) developed a National Strategic Health Development Plan (NSHDP, 2010-2015) prioritizing strengthening of PHC services. A partnership must be formed between the various administrative levels (federal, state and local government authorities) to support an effective delivery of PHC services. The implementation of the NSHDP requires ensuring sustainable financing, efficient use of resources as well as accountability of expenditure, for a functioning and results-oriented delivery system, and especially at the PHC level.
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Despite a substantial improvement in controlling new infections of HIV over the last ten years, Mexico is experiencing a low-level epidemic with approximately 180,000 people living with HIV (Spectrum, 2013), making it the fourth ranking country in Latin America with regards to the number of people with the disease (PLHIV).
... See More + The objective of increasing coverage and reducing inequality in the country is reflected in the objectives of the Specific Action Program (PAE) for the national response to HIV, AIDS and STI of 2013-2018 (Secretaria de salud), which seeks to decrease the effect of HIV and STIs, implement prevention strategies and provide comprehensive care for vulnerable population groups and those living in poverty. The possibility of achieving the objectives of the PAE is closely related to the total amount of resources that Mexico can commit to fighting HIV and the way these resources are allocated. In the hopes of assisting the Government of Mexico in further strengthening its HIV investment, the authors try to answer the question How can HIV funding be optimally allocated to the combination of HIV response interventions that will yield the highest impact in the shortest period. The study found that despite the overall greater costs of treatment with ART, this is the most cost-effective program. ART not only reduces deaths but is an effective measure to prevent new infections due to the reduction of viral load to undetectable levels. As such, the most cost-effective allocation – with no additional resources of current Program funds, is to scale up treatment, by about 4 to 8 percent, to maximize ART coverage while slightly reducing overall allocations to general population prevention.This slight increase would avert 4,235 deaths and 3,371 new infections, and improve health outcomes by around 6 percent. To increase the value-for-money of existing resources, allocation efficiency would also require the strengthening of CENSIDA´s stewardship role, to ensure that the funds transferred are invested as they were initially earmarked.
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The development objective of the Sindh Enhancing Response to Reduce Stunting amd Malnutrition Project for Pakistan is to expand, in selected areas, the coverage of a multi-sectoral package ofinterventions, and improve behaviors, and practices in selected sectors, which have been proven to contribute to reducing stunting and malnutrition.
... See More + Some of the negative impacts are includes : (i) air quality deterioration due to dust emissions; (ii) solid waste management for school toilets during construction and operation; (iii) unsuitable toilet construction may lead to water contamination; (iv) surface and ground water quality deterioration due to runoff from community toilets; (v) use of adulterated/ banned pesticide; (vi) health and safety hazards for the farmers; (vii) impacts on Women, Children, and Vulnerable Groups; Some of the mitigation measures are includes : (i) soil and temporary spoil piles should be covered or sprayed with water if generating dust; (ii) effluents from the construction sites will not be released to drinking water sources, cultivation fields, irrigation channels, and critical habitats. Appropriate effluent treatment arrangements such as settling tanks will be made at the site; (iii) flush toilets should not be encouraged in areas under the project where water is scarce and in dry season; (iv) ensured through consultation and awareness that the wastes are not released into any drinking water source, cultivation fields, or critical habitat; (v) banned and adulterated pesticide list will be disseminated to farmers and awareness will be given via Farmer Field School (FFS); (vi) judicious use of the irrigation water, chemical inputs and use of alternate techniques (such as integrated pest management, using disease-resistant seeds, and mulching) will be promoted through awareness raising and capacity building initiative; (vii) awareness and capacity building regarding Material Safety Data Sheet (MSDS) for each hazardous substance will be promoted; (viii) waste effluents will be released in irrigation channels only if they do not negatively affect the irrigation water quality; (ix) Use of Bio-pesticides and organic fertilizer will be encouraged;
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The development objective of the Improvement of Solid Waste Management to Support Regional and Metropolitan Cities Project for Indonesia is to support the implementation of the government’s national program to improve solid waste management services for selected urban populations across Indonesia.
... See More + Some of the negative impacts and mitigation measures are include : (i) dissemination of information regarding project activities to waste-pickers and potentially affected peoples; (ii) stakeholder engagement plan that include public consultation and Proper dissemination of information to affected communities; (iii) identification of goods and services that can be provided by local suppliers; (iv) organize and implement Health and safety induction to all workers; (v) develop and implement transportation management plan that includes usage of material cover during material transportation and/or perform dust control by spraying water on the streets & roads when mobilization is performed during a particular hot day (dry season) twice a day (noon and afternoon); (vi) maintain site roads in good condition to reduce noise and vibration from vehicle movements; (v) traffic management plan should be developed and implemented to ensure minimal traffic disruption; (vi) Install wind fencing upwind of the tipping area to reduce the wind strength as it crosses the facility; (vii) installation of barriers around demolition works area to minimize noise and not doing any construction works at night; (viii) develop and implement a working plan to control and minimize demolition debris material run-off; (ix) installation of barriers around civil works area to minimize noise and not doing any construction works at night; (x) provide waste pickers with appropriate protective clothing, gloves, respiratory face masks and slip resistant shoes and hard soled safety shoes to avoid puncture wounds to the feet; (xi) conduct socialization regarding occupational health and safety matter to all waste pickers; (xii) develop and implement transportation management plan that includes usage of material cover during material transportation and/or perform dust control by spraying water on the streets & roads when mobilization is performed during a particular hot day (dry season) twice a day (noon and afternoon); (xiii) minimize the daily exposed working face and use perimeter drains and landfill cell compaction, slopes and daily cover materials to reduce infiltration of rainfall into the deposited waste; (xiv) include landfill gas collection system designed and operated in accordance with the applicable national requirements.
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