Cases of human immunodeficiency virus (HIV) infections were first detected in Malaysia in 1986. Since then, the number of new HIV cases has been increasing steadily to a peak of 6,978 new cases detected in 2002 then declining to 3,438 new cases in 2012.
... See More + In response to the escalating epidemic, the Government of Malaysia (GOM) agreed the implementation of needle syringe program (NSP) and methadone maintenance therapy (MMT) programs against much public opposition which viewed these programs as being against the Islamic religion and will encourage more people to use drugs. The main objectives of this study are to evaluate whether the harm reduction program in Malaysia is cost-effective and also whether they provide return on investments (ROIs) to the government. The study used an epidemiologic mathematical model of HIV transmission and disease progression, called the projection and evaluation tool (Prevtool) developed by a team of investigators at the Kirby Institute, University of New South Wales, Australia to simulate the impact of MMT and NSP on the transmission of HIV among people who inject drugs (PWIDs) in Malaysia. Briefly, the model simulates the number of PWID who become infected with HIV over time as well as the extent of disease progression among those infected in the presence and absence of harm reduction program in the country. This study has shown that the combined MMT and NSP programs as implemented in Malaysia are cost-effective and are expected to produce net cost-savings to the government in the future. Evidence of cost-effectiveness and expected cost-savings support policy recommendation that both MMT and NSP programs should be maintained as part of the key strategy to control HIV spread among PWIDs in Malaysia. Study findings that even with the present program coverage, harm reduction activities are expected to become more cost-effective and cost-saving in the future suggest that policies towards program expansion may demonstrate higher value for money.
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Working Paper 88083 JUL 01, 2014
Naning, Herlianna; Kerr, Cliff; Kamarulzaman, Adeeba; Osornprasop, Sutayut; Dahlui, Maznah; Ng, Chiu-Wan; Wilson, David P.
Ratings for the Avian and Human Influenza Preparedness and Response Project for Uganda were as follows: outcomes were moderately satisfactory, the risk to global environment outcome was moderate, the Bank performance was moderately satisfactory, and the Borrower performance was also moderately satisfactory.
... See More + Some lessons learned included: for civil works contracts under execution, it is important for the Borrower's contract managers to supervise the contractor regularly (such as weekly) to establish the capacity/readiness of the contractor. The frequency of visits can be increased or reduced depending upon the contractor's strengths or other measures taken for noted poor performance. Adequately engaging key parliamentarians about the project's broad scope and the varied and persistent nature of the threats addressed under the project could have potentially facilitated an expedited and favorable consideration of the project in Parliament. It is particularly important that relevant parliamentary sectoral committees be closely associated with the project preparation process. With the growing and persistent threat from zoonotic diseases, a culture and effective modi operandi of collaboration between the ministries in charge of health and livestock are critical in ensuring adequate monitoring of, and rapid response to major zoonotic disease outbreaks.
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Implementation Completion and Results Report ICR3144 JUN 30, 2014
Ratings for the Prevention and Management of Influenza Type Illness and Strengthening of Argentina's Epidemiological System Project for Argentina were as follows: outcome was satisfactory, risk to development outcome or global environment outcome was moderate, Bank performance was satisfactory, Borrower (of guaranteed loan) and implementing party performance was satisfactory, and Government performance was satisfactory.
... See More + Some lessons learned included: Argentina's adoption of a high-risk targeted vaccination strategy against A-H1N1 influenza was effective in containing the epidemic. A comprehensive (human and animal) pandemic preparedness plan will benefit from moving from a response approach using emergency instruments to one that favors preventive risk reduction and risk management through regular country program and operations. High-risk groups can only be reached through an intense communication effort. Despite a short preparation period, it is important to avoid having tunnel vision and think broadly when designing emergency loans. The execution of projects within existing technical and administrative structures has significant positive externalities. A result-based financing (RBF) model is a valuable strategy to influence subnational government policies in federal systems. The World Bank should re-evaluate the objective of the emergency recovery loan instrument and its consistency with other fiduciary policies.
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Implementation Completion and Results Report 89199 JUN 25, 2014
Ratings for the Health, Nutrition, and Population Sector Program Project for Bangladesh were as follows: outcome was moderately satisfactory, risk to development outcome was moderate, Bank performance was moderately satisfactory, and Borrower performance was moderately satisfactory.
... See More + Some lessons learned included: complex challenges, such as child nutrition, is beyond the scope of the health sector by itself and requires a multi-sectoral approach. The World Bank can play a role in convening development partners and to ensure that the evidence is shared across different sectors, in much the same way that was done with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) and the three ones approach. Not having a clear development objective can impact negatively on implementation and results. The lack of intervention-level evaluations limits the programs flexibility and responsiveness. While monitoring and evaluation is important for accountability, it can also help to understand what works well in the program and what needs to be modified. Having a well-designed results framework is important for planning and monitoring. Without a structure for partners and the government to design, debate, and evaluate new policy, it seems unlikely that there will be structural reform in the future. It also requires development partners to strengthen their understanding of political economy and to develop strategies to gradually expand their dialogue. At the same time, the government needs to identify its priorities and openly discuss its political limitations.
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Project Performance Assessment Report 88078 JUN 24, 2014
This brief is about preventing Neglected Tropical Diseases (NTDs) of poverty. The control of onchocerciasis (river blindness) is widely acknowledged to be one of the major public health achievements of recent decades in Africa.
... See More + Lessons from the implementation of the Onchocerciasis Control Programme (OCP) led to a stronger partnership approach in the African Programme for Onchocerciasis Control (APOC). A key contributor to the success of APOC is the diversity and depth of its public-private partnership, which has brought together communities, policymakers and health workers in endemic countries, UN organizations, multilateral and bilateral agencies, donors, private foundations, and non-governmental development organizations (NGDOs) to successfully deliver preventative medication. The World Health Organization (WHO) serves as the implementing agency, working with countries and NGDOs while the World Bank, working with other development partners, is the programs fiscal agent. This brief contains the following headlines: The WHO APOC secretariat : playing many roles; Centralized financial management : the role of the World Bank and other Development partners; Sponsoring agencies : the evolving role of the UN system and multilateral partners; the Mectizan donation program : a groundbreaking effort by the private sector; and NGDOs : the backbone of the partnership.
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This brief is about preventing Neglected Tropical Diseases (NTDs) of poverty. The control of onchocerciasis (river blindness) is widely acknowledged to be one of the major public health achievements of recent decades in Africa.
... See More + Lessons from the implementation of the Onchocerciasis Control Programme (OCP) led to a stronger partnership approach in the African Programme for Onchocerciasis Control (APOC). A key contributor to the success of APOC is the diversity and depth of its public-private partnership, which has brought together communities, policymakers and health workers in endemic countries, UN organizations, multilateral and bilateral agencies, donors, private foundations, and non-governmental development organizations (NGDOs) to successfully deliver preventative medication. The World Health Organization (WHO) serves as the implementing agency, working with countries and NGDOs while the World Bank, working with other development partners, is the programs fiscal agent. This brief contains the following headlines: The WHO APOC secretariat : playing many roles; Centralized financial management : the role of the World Bank and other Development partners; Sponsoring agencies : the evolving role of the UN system and multilateral partners; the Mectizan donation program : a groundbreaking effort by the private sector; and NGDOs : the backbone of the partnership.
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This report concerns the second additional financing for the Second Health Sector Support Program for Cambodia that will improve access to, and utilization of effective, efficient and quality health services to the population.
... See More + The project aims to achieve this by (a) strengthening primary health care and essential referral services, (b) strengthening health financing and social protection mechanisms for the poor; and (c) strengthening human resources and institutional capacity on the Ministry of Health. Since no new activities will be introduced under the second additional financing, the nature and scale of impact that may occur on indigenous peoples are expected to be similar to those under the original project and the first additional financing, and the IP communities will continue to benefit from this additional financing. The social assessment undertaken during the preparation of the second additional financing ascertained continued broad community support of indigenous peoples communities to the Second Health Sector Support Program. It also showed that despite the achievements made during the original project and the first additional financing, ethnic minorities still face challenges in accessing quality health care services and tend to be vulnerable to poor health. These challenges include: 1) poor access to health care services; 2) costs are unaffordable; 3) limited ethnic minority participation in health management structure and planning process; 4) health workers are not from local communities; and 5) limited community health education and awareness raising activities. The second additional financing will not finance civil works and concerns four project components: component A will strengthen health service delivery; component B will improve health financing; component C will strengthen human resources; and component D will strengthen health system stewardship functions. No additional funding is available for components C and D. Continued financing of health equity funds and service delivery grants is consistent with the program's development objective. As with the original project and the first additional financing, the second additional financing is expected to have a positive impact on the lives of peoples throughout Cambodia, particularly the poorest, by improving their access to and utilization of effective and efficient health services. The second additional financing will not affect any natural habitats, forests, or cultural resources. No new safeguard policies will be triggered by the second additional financing.
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Malaria continues to be a prominent global public health challenge, in part because of the slow population adoption of recommended preventive and curative behaviors.
... See More + This paper tests the effectiveness of two service delivery models designed to promote recommended behaviors, including prompt treatment seeking for febrile illness, in Odisha India. The tested modules include supportive supervision of community health workers and community mobilization promoting appropriate health seeking. Program effects were identified through a randomized cluster trial comprising 120 villages from two purposively chosen malaria-endemic districts. Significant improvements were measured in the reported utilization of bed nets in both intervention arms vis-à-vis the control. Although overall rates of treatment seeking were equal across the study arms, treatment seeking from community health workers was higher in both intervention arms and care seeking from trained providers also increased with a substitution away from untrained providers. Further, fever cases in both treatments were more likely to have received timely medical treatment (within 24 hours) from a skilled provider. The study arm with supportive supervision was particularly effective in shifting care seeking to community health workers and ensuring prompt diagnosis and treatment. A community-based intervention combining the supportive supervision of community health workers with intensive community mobilization can be effective in shifting care seeking and increasing preventive behavior, and thus may be used to strengthen the national malaria control program.
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Policy Research Working Paper WPS6901 JUN 01, 2014
Das, Ashis; Friedman, Jed; Kandpal, Eeshani; Ramana, GNV; Das Gupta, R K; Pradhan, Madan M; Govindaraj, Ramesh
This brief presents an historical timeline about preventing Neglected Tropical Diseases (NTDs) of poverty. For the past 40 years, the endemic countries of Africa together with the World Health Organization (WHO), World Bank and other development partners, the pharmaceutical industry, and non-governmental organizations have prioritized the control of river blindness through the Onchocerciasis (river blindness) Control Programme (OCP) and the African Programme for Onchocerciasis Control (APOC).
... See More + Plans are underway to help APOC extend its operations beyond 2015 and transition from a single-disease entity to an expanded regional NTD initiative entitled Programme for the Elimination of Neglected Diseases in Africa (PENDA). This new regional entity may build on the governance structure of APOC, and increase technical assistance to support elimination goals, especially in surveillance, evaluation, resource tracking and mobilization, and coordination.
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This brief presents an historical timeline about preventing Neglected Tropical Diseases (NTDs) of poverty. For the past 40 years, the endemic countries of Africa together with the World Health Organization (WHO), World Bank and other development partners, the pharmaceutical industry, and non-governmental organizations have prioritized the control of river blindness through the Onchocerciasis (river blindness) Control Programme (OCP) and the African Programme for Onchocerciasis Control (APOC).
... See More + Plans are underway to help APOC extend its operations beyond 2015 and transition from a single-disease entity to an expanded regional NTD initiative entitled Programme for the Elimination of Neglected Diseases in Africa (PENDA). This new regional entity may build on the governance structure of APOC, and increase technical assistance to support elimination goals, especially in surveillance, evaluation, resource tracking and mobilization, and coordination.
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This brief is about preventing Neglected Tropical Diseases (NTDs) of poverty. There is global support for the control and elimination of NTDs in low income countries.
... See More + In 1974, the Onchocerciasis Control Programme (OCP) was launched in West Africa to combat the devastating effects of river blindness. Since then the control of river blindness has been a remarkable success story. Now, focus has shifted to a more ambitious goal: the elimination of river blindness in addition to other preventable neglected tropical diseases (NTDs) from Africa. To help countries achieve this aim, plans are underway to transition the African Programme for Onchocerciasis Control (APOC) into the regional NTD Programme for the Elimination of Neglected Diseases in Africa (PENDA). It is hoped that PENDA will help ensure that future generations live free from the threat of debilitating diseases of poverty. This brief contains the following headlines: Health system strengthening and enhanced program sustainability through community action; Disease control and elimination; Impact on health, human development, and agriculture; Return on investment; and Looking forward.
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This brief is about preventing Neglected Tropical Diseases (NTDs) of poverty. There is global support for the control and elimination of NTDs in low income countries.
... See More + In 2012, as part of the London Declaration on NTDs, the pharmaceutical industry collectively committed to donate most of the drugs necessary for an Africa-wide NTD program. For the past 40 years, the endemic countries of Africa together with the World Health Organization (WHO), World Bank and other development partners, the pharmaceutical industry, and non-governmental organizations have prioritized the control of river blindness through the Onchocerciasis (river blindness) Control Programme (OCP) and the African Programme for Onchocerciasis Control (APOC). This brief contains the following headlines: Community health systems provide a way forward; Collaboration is key; Increased WHO technical assistance; Timeline for elimination; Ensuring that health systems effectively address Intensive Disease Management (IDM) NTDs; and New funding strategies from the World Bank.
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This brief is about preventing Neglected Tropical Diseases (NTDs) of poverty. There is global support for the control and elimination of NTDs in low income countries.
... See More + In 1974, the Onchocerciasis Control Programme (OCP) was launched in West Africa to combat the devastating effects of river blindness. Since then the control of river blindness has been a remarkable success story. Now, focus has shifted to a more ambitious goal: the elimination of river blindness in addition to other preventable neglected tropical diseases (NTDs) from Africa. To help countries achieve this aim, plans are underway to transition the African Programme for Onchocerciasis Control (APOC) into the regional NTD Programme for the Elimination of Neglected Diseases in Africa (PENDA). It is hoped that PENDA will help ensure that future generations live free from the threat of debilitating diseases of poverty. This brief contains the following headlines: Health system strengthening and enhanced program sustainability through community action; Disease control and elimination; Impact on health, human development, and agriculture; Return on investment; and Looking forward.
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This brief is about preventing Neglected Tropical Diseases (NTDs) of poverty. There is global support for the control and elimination of NTDs in low income countries.
... See More + In 2012, as part of the London Declaration on NTDs, the pharmaceutical industry collectively committed to donate most of the drugs necessary for an Africa-wide NTD program. For the past 40 years, the endemic countries of Africa together with the World Health Organization (WHO), World Bank and other development partners, the pharmaceutical industry, and non-governmental organizations have prioritized the control of river blindness through the Onchocerciasis (river blindness) Control Programme (OCP) and the African Programme for Onchocerciasis Control (APOC). This brief contains the following headlines: Community health systems provide a way forward; Collaboration is key; Increased WHO technical assistance; Timeline for elimination; Ensuring that health systems effectively address Intensive Disease Management (IDM) NTDs; and New funding strategies from the World Bank.
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Using data from an experimental supportive intervention to India's malaria control program, this paper studies the impact of leveraging local non-state capacity to promote mosquito net usage and recommended fever care-seeking patterns.
... See More + The supportive activities were conducted simultaneously by three nongovernmental organizations in two endemic districts in the state of Orissa. The study finds that program impact varied significantly by location. Examining three potential sources of this variation (differential population characteristics, differential health worker characteristics, and differential implementer characteristics), the analysis provides evidence that both population and nongovernmental organization characteristics significantly affected the success of the program. The paper discusses these findings as they relate to the external validity of development policy evaluations and, specifically, for the ability of the health system to benefit from limited non-state capacity in under-resourced areas.
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Policy Research Working Paper WPS6931 JUN 01, 2014
The additional financing for the Health Sector Support Investment Project of Cameroon, which does not differ from the original project, is to improve health outcomes among women and children in targeted areas of Cameroon.
... See More + To that end, the PDO also remains the same and it is to increase utilization and improve the quality of health services with a particular focus on child and maternal health and communicable diseases. A grant from the Health Results Innovation Multi Donor Trust Fund (HRITF) of US$20 million will be used in the original project areas for two purposes: (i) to scale-up the activities of the project in the 26 districts currently implementing Performance-Based Financing (PBF) through extending PBF to the impact evaluation control group facilities) and (ii) to allow for the impact evaluation to be completed and results used to fine tuning PBF national strategy. The proposed Additional Financing will help to better align IDAs support to Cameroons health system with an enhanced focus on results. It will also support the Governments commitment to improve access to quality health services for women and children in rural areas with a focus on the poor. The project consists of two components. The first component involves district service delivery where the 26 districts currently covered by the project and the eight additional departments where PBF will be scaled-up, this component will provide PBF payments. The second component supports institutional strengthening at national, regional, and district levels, particularly focusing on PBF contract design and management and establishing a unified health management and geographic information system to generate up to date, reliable, financial and programmatic data. The Component also supports project management and implementation.
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The development objective of the Guizhou Rural Development and Poverty Alleviation Project for China is to develop and implement models for agricultural sector restructuring and modernization, improved organizational arrangements, and strengthened public service delivery in Guizhou's poverty stricken areas which increase rural income in an equitable and socially acceptable way.
... See More + Some of the negative impacts and mitigation measures include: To properly settle down the problems caused by the project on the society, economy and environment and make sure the environment within the project area can meet the functional requirements of the environment; to control soil erosion due to the destruction of vegetation and soil excessive use of resources, and agricultural chemical pollution, maintain the integrity of the ecosystem, ecological balance and diversity as well as protect the rare and endangered species and ancient woods with great value; to control the emissions of noise, waste water and solid waste during the construction and operation period, and protect the air, sound and water in the surrounding environment; to meet the planting and aquaculture planning of agriculture, forestry, animal husbandry and protect the farmland, woodland and grassland in the protected areas; to respect local customs in ethnic minority areas, and protect minority activities, nature reserves, drinking water source, scenic areas, heritage areas, world heritage sites and forest parks from destroy.
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The development objective of the Guizhou Rural Development and Poverty Alleviation Project for China is to develop and implement models for agricultural sector restructuring and modernization, improved organizational arrangements, and strengthened public service delivery in Guizhou's poverty stricken areas which increase rural income in an equitable and socially acceptable way.
... See More + Some of the negative impacts and mitigation measures include: To properly settle down the problems caused by the project on the society, economy and environment and make sure the environment within the project area can meet the functional requirements of the environment; to control soil erosion due to the destruction of vegetation and soil excessive use of resources, and agricultural chemical pollution, maintain the integrity of the ecosystem, ecological balance and diversity as well as protect the rare and endangered species and ancient woods with great value; to control the emissions of noise, waste water and solid waste during the construction and operation period, and protect the air, sound and water in the surrounding environment; to meet the planting and aquaculture planning of agriculture, forestry, animal husbandry and protect the farmland, woodland and grassland in the protected areas; to respect local customs in ethnic minority areas, and protect minority activities, nature reserves, drinking water source, scenic areas, heritage areas, world heritage sites and forest parks from destroy.
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