The development objectives of the Serving People, Improving Health Project for Ukraine are to improve the quality of health services in selected Oblasts, with special focus on primary and secondary prevention of cardiovascular diseases and cancer, and to enhance efficiency of the health care system.
... See More + The project is made up of three components. Under component 1 (Improving service delivery at the local level) the Project provides financing to selected Oblasts to carry out investment sub-projects aimed at prevention, early detection and treatment of cardiovascular diseases and cancer and at increasing efficiency of their health care delivery system (Oblast Sub-projects), including activities focused on improving primary health care, fighting cardiovascular diseases (CVDs) at the primary and secondary care levels, early cancer detection, and health delivery system rationalization. Component 2 (Strengthening Ministry of Health MoH governance) has been clustered around five thematic areas, with MoH as implementing agency: Payment System Reform, eHealth - Information Systems Development, Public Health, Information and Communication, and Capacity Building. In addition, a decision has been made to bundle the resources of the five subcomponents into a common pool. Component 3 (Project implementation support, and monitoring and evalutation) supports the Project Consultancy Support Unit (PCSU) at national level, responsible for Project implementation support and technical assistance to the Oblasts. In addition, it would sponsor complementary data collection and analytical activities for monitoring results. Information from the existing Health Management Information System (HMIS) is complemented through audit of medical records on a sample basis, as well as through evidence based on specific, ad hoc household and facility surveys. In addition, the Project organizes learning events to educate and promote better use of evidence for policy.
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Adolescent Sexual and Reproductive Health (ASRH) is one of five areas of focus of the World Banks Reproductive Health Action Plan 2010 - 2015 (RHAP), which recognizes the importance of addressing ASRH as a development issue with important implications for poverty reduction.
... See More + A couple key messages relayed in this brief as follows: Sexually transmitted infections (STIs), including HIV, present a serious challenge to the health and well-being of adolescents, particularly young women, who are at greater risk of infection; An analysis of data from six countries namely, Bangladesh, Burkina Faso, Ethiopia, Nepal, Niger, and Nigeria found that self-reported STIs and symptoms are low among adolescents. Although less than a third of adolescents in any of the countries have comprehensive knowledge about HIV/AIDS, more never-married adolescent women have comprehensive knowledge about HIV transmission and prevention as compared to their ever-married counterparts. Knowledge of STIs is higher in urban than rural areas.
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The most severe impact of the Ebola epidemic, which began in Guinea in December 2013 and quickly spread to Liberia and Sierra Leone, has been in lost human lives and suffering.
... See More + This report, prepared for the World Economic Forum at Davos, focuses on the indirect, economic costs, in particular the effects on economic output in 2015. Most of the economic cost is driven by aversion behavior, which consists of both the actions taken by individuals to avoid exposure to the illness and actions taken by investors in anticipation of those individual choices. The report first estimates the impact of the epidemic on gross domestic product (GDP) in Guinea, Liberia, and Sierra Leone. Here the report builds on sector-specific analysis to update World Bank forecasts for the three countries, and incorporates recent results of World Bank-financed cellphone surveys in Liberia and Sierra Leone. The authors evaluate the economic effects of the epidemic on the continent, beyond the three hardest-hit countries, using assessments by World Bank country economists across the 48 countries of sub-Saharan Africa. Finally, the report updates estimates from the global economic model of the research arm of the World Bank, to quantify the 2015 impact of the potential spread of the epidemic to other countries. Updated general equilibrium analysis suggests that further spread of the epidemic to other African economies, if the epidemic is not contained and instances of infection continue to occur in other countries, can potentially exact an economic toll of the order of 6 billion dollars. The results underscore the importance of: (a) Ebola and broader pandemic preparedness in African countries; and (b) reaching the goal of zero new cases as soon as possible in the three most affected countries.
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Working Paper 93721 JAN 20, 2015
Thomas, Mark Roland; Smith, Gregory; Ferreira, Francisco H. G.; Evans, David; Maliszewska, Maryla; Cruz, Marcio; Himelein, Kristen; Over, Mead
Malnutrition among both women and children remains a major health issue in rural Pakistan. They also lack voice in relation to important health and nutritional decisions within their homes, for both themselves and their children, and they are systematically excluded from decision making at the community level.
... See More + This study assesses the extent to which: (1) increasing the participation of women in the public sphere results in an increased use of health facilities, particularly for child and maternal needs, and in improved health outcomes; and (2) whether targeted interventions that provide information on health status and health behaviors needed for better hygiene and disease prevention are necessary for substantial improvements in health status, over and above any impacts of empowerment. This study builds upon an existing evaluation of a Pakistan poverty alleviation fund project (a World Bank supported community based development initiative) which investigates the impact of mobilizing communities into village support organizations (VSOs) and providing them with village level grants for community infrastructure development and livelihood enhancement. The health score card will provide specific information regarding minimum standards of service delivery and quality of care at the local level (basic health units (BHUs), primary health care (RHCs), and lady health workers (LHWs)). This will allow further exploration of additional impacts of increasing awareness through targeted information provision with and without a strengthening of the door to door delivery system via the LHW.
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Malnutrition is responsible for nearly half (45 percent) of all deaths in children under five. Children who are undernourished between conception and age two are at high risk for impaired cognitive development, which adversely affects the countrys productivity and growth.
... See More + The World Bank is supporting nutrition-related interventions through multiple projects. For example, the PNPM Generasi Sehat dan Cerdas (National Program for Community Empowerment, Healthy and Bright Generation) has set nutrition-sensitive targets including improving the use of maternal and child health services and consumption of Vitamin A for children under five. In 2014, PNPM Generasi is expected to extend to three more provinces, and to include a new focus on stunting reduction by providing IYCF (Infant and Young Child Feeding) training to service providers and community volunteers to improve their counseling skills. In the PKH/Program Keluarga Harapan, a conditional cash transfer is being piloted to focus on improving the health and education services utilization including prenatal and postnatal check-ups, professionally attended birth, growth promotion and monitoring, Vitamin A supplementation, etc. At the policy level, the World Bank is supporting the Review of Double Burden of Malnutrition (DBM) in Indonesia to discuss the magnitude and causes of this emerging problem, and to improve the capacity and governance to address the DBM in the country.
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The association between hygiene, sanitation, and health is well documented, yet thousands of children die each year from exposure to contaminated fecal matter.
... See More + At the same time, evidence on the effectiveness of at-scale behavior change interventions to improve sanitation and hygiene practices is limited. This paper presents the results of two large-scale, government-led handwashing and sanitation promotion campaigns in rural Tanzania. For the campaign, 181 wards were randomly assigned to receive sanitation promotion, handwashing promotion, both interventions together, or neither. One year after the end of the program, sanitation wards increased latrine construction rates from 38.6 to 51 percent and reduced regular open defecation from 23.1 to 11.1 percent. Households in handwashing wards show marginal improvements in handwashing behavior related to food preparation, but not at other critical junctures. Limited interaction is observed between handwashing and sanitation on intermediate outcomes: wards that received both handwashing and sanitation promotion are less likely to have feces visible around their latrine and more likely to have a handwashing station close to their latrine facility relative to individual treatment groups. Final health effects on child health measured through diarrhea, anemia, stunting, and wasting are absent in the single-intervention groups. The combined-treatment group produces statistically detectable, but biologically insignificant and inconsistent, health impacts. The results highlight the importance of focusing on intermediate outcomes of take-up and behavior change as a critical first step in large-scale programs before realizing the changes in health that sanitation and hygiene interventions aim to deliver.
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Policy Research Working Paper WPS7164 JAN 01, 2015
Briceno, Bertha; Coville, Aidan; Martinez , Sebastian
The Congo Health Sector Services Development Project received a moderately satisfactory outcome with moderate risk to development. Both the Bank and the Borrower received moderately satisfactory ratings for their performances.
... See More + Component 1 was found to be too ambitious with little design built in. Thus, the objective of the component was changed from Strengthening leadership capacities of Ministry of Health, Social Services and Family Welfare (MSASF) in managing a functioning and decentralized health system to Access to a package of high priority health services aimed at addressing the three health problems that account for the largest share of the burden of disease in the Congo: malaria, maternal and child mortality, and interrupting the transmission of mother to child of the HIV virus. Component 3 would become Component 2 to provide support to new Component 1 and include rehabilitating and equipping of primary health care covered by performance based financing, and safe disposal of biomedical waste in these facilities. Activities under Component 4 were narrowed and put under the new Component 1 and delivered through a performance based financing pilot. Five lessons were learned from this project and are as follows: (1) A preliminary political economy assessment may help identify appropriate institutional frameworks for project coordination. (2) For large-scale, complex projects a dedicated team of professionals must be created for effective implementation. (3) Streamline resources to the beneficiaries. In situations where leadership and coordination remain weak at the central level, efficient and effective interventions that streamline resources to the decentralized level where services are provided to the target population should be introduced. (4) Reliance on significant counterpart and development partner financing can impede achieving project results. (5) Reinforce Monitoring and Evaluation systems through a two-pronged approach can have significant effect.
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Implementation Completion and Results Report ICR3204 DEC 30, 2014
The Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response for Vietnam received a highly satisfactory outcome with moderate risk to development outcome.
... See More + Both the Bank and the Borrower received a satisfactory performance rating. Components were not revised during the project life, and there were no other significant changes in design, scope and scale, and implementation arrangements. The following lessons can help inform future programs that build veterinary and human public health systems for prevention and control of diseases: (1) An emergency is an opportunity to reduce risks over the medium term. This will help prevent future costly emergencies. (2) One Health approaches are effective in disease control and prevention. (3) One Health approaches are feasible when there is good leadership. (4) Behavior change takes time and resources. (5) Upstream attention to environmental impacts helps prevent problems. (6) Transition from emergency response to systemic improvements is important. (7) Successful market upgrades. (8) ME indicators. Final outcome indicators (such as disease prevalence and the case fatality ratio) are by themselves not sufficient to evaluate progress and thus may be misleading. They need to be complemented by measures of system performance for functions that are required for disease control and prevention. (9) Technical definitions are critical for ME. (10) Use of consultants. External expertise was essential for the highly technical task of improving laboratories and their management. (11) Decentralized implementation. This was both necessary (because disease control and prevention activities occur in numerous districts and villages) and challenging (because local capacity was uneven and alignment with national policies and programs was required). (12) Engaging stakeholders beyond Ministry of Health (MOH) and Ministry of Agriculture and Rural Development (MARD). (13) Training health workers on communications, especially risk communications. This helped extend messages to communities and improved infection control in health care facilities. (14) Rule to balance expenditures on training and equipment in health care centers. (15) Quality of supervision and implementation support. Substantial implementation support was instrumental to the success of this technically complex, emergency, and multisectoral operation.
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Implementation Completion and Results Report ICR3330 DEC 23, 2014
This issue of the Human development quarterly update includes the following topics of interest: latest research findings; new articles and books; in the news; and on the blogs; references; and previous issues.
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Beyond the terrible toll in human lives and suffering, the Ebola epidemic currently afflicting West Africa is already having a measurable economic impact in terms of forgone output, higher fiscal deficits, rising prices, lower real household incomes, and greater poverty.
... See More + These economic impacts include the costs of healthcare and forgone productivity of those directly affected but, more importantly, they arise from choices by others to avoid exposure to the disease, called aversion behavior. This report provides a systematic analysis of the channels of economic impact and the likely magnitude of that impact for Guinea, Liberia, and Sierra Leone, as well as West Africa as a whole. The short-term (2014) impact of Ebola on economic output is on the order of US$359 million in foregone output in 2013 prices. Two alternative scenarios are used to estimate the medium-term (2015) impact of the epidemic. A low Ebola scenario corresponds to rapid containment within the three most severely affected countries, while high Ebola corresponds to slower containment in the core three countries, with some broader regional contagion. The estimates of the GDP lost as a result of the epidemic in the core three countries for 2015 alone sum to US$97 million under low Ebola (implying some recovery from 2014), and US$809 million under high Ebola (in 2013 dollars). Over the medium term, however, both epidemiological and economic contagion in the broader sub-region of West Africa is likely. This report uses a multi-country general equilibrium model to estimate the medium-term impact on output for West Africa as a whole. Under low Ebola, the loss in GDP for the sub-region is estimated to be US$2.2 billion in 2014 and US$1.6 billion in 2015. Under high Ebola, the estimates are US$7.4 billion in 2014, and US$25.2 billion in 2015. This analysis shows that the economic impacts are already very serious in the core three countries, particularly Liberia and Sierra Leone, and could become catastrophic under a slow-containment, high Ebola scenario. In broader regional terms, the economic impacts could be limited if immediate national and international responses succeed in containing the epidemic and mitigating aversion behavior. If, on the other hand, the epidemic spreads into neighboring countries, some of which have much larger economies, the cumulative two-year impact could reach US$32.6 billion by the end of 2015, almost 2.5 times the combined 2013 GDP of the core three countries.
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The Health System Strengthening for Better Material and Child Health Results of Congo has an objective to improve utilization and quality of maternal and child health services in targeted areas within the Recipients territory.
... See More + The primary focus of the project will be on maternal and child health (MCH) with improvements in health service delivery achieved though the scale-up and strengthening of PBF in the target areas. In addition to improving utilization and quality of MCH services, PBF will also address the abovementioned health system challenges by improving the health financing and health policy capacities and by focusing on 1) human resources for health outcomes (motivation, distribution, etc.), 2) financial accessibility to health services, 3) availability of quality and affordable medicines; 4) community engagement, and 5) improvement of data availability. The project will have three components. Component one: Improve Utilization and Quality of Health Services at Health Facilities through Performance-Based Financing; Component two: Improve Governance, Purchasing and Coaching and Strengthen Health Administration Directorates and Services through Performance Based Financing; and Component three: Strengthen Health System Performance Financing, Health Policy, and Surveillance Capacities. Component one would be supported by IDA and the HRITF as well as through parallel funding from UNICEF, Global Fund and GAVI. Component two will focus on contract management and verification: an innovative purchasing arrangement will be created covering each of the four provinces. Component three is supporting components one and two; it will focus on institutional capacity building and technical support in various dimensions of health system strengthening that will directly reinforce the investments of components one and two.
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The purpose of drafting this plan is to, through implementing the policy of prioritizing prevention and comprehensive control, to set up ten to twenty exemplary demonstration bases, introduce the conception of integrated pest management (IPM), offer IPM technique technologies trainings for farmers, grass-roots agricultural technique technologies cohorts and staff from the project office, and widely exercise large scale prevention and control against plants pests plant pests and animals diseases animal diseases.
... See More + The pests prevention and control should cut the outbreak by more than 90 percent, the utilized dosage of pesticides by over 30 percent, and the usage of chemical drugs in the core green exemplary demonstration areas by above 50 percent. We hope the average mortality of sheep and beef cattle can be lowered by 2 percent and 4 percent respectively compared with the level prior to this project. The foot-and-mouth disease and parasites among other animals epidemics of sheep and beef cattle must also be effectively contained, with certain localities reaching purification standards. Such major zoonoses as Brucella should be substantially curbed, while the prevention capacity against imported epidemics must be significantly enhanced.
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The purpose of drafting this plan is to, through implementing the policy of prioritizing prevention and comprehensive control, to set up ten to twenty exemplary demonstration bases, introduce the conception of integrated pest management (IPM), offer IPM technique technologies trainings for farmers, grass-roots agricultural technique technologies cohorts and staff from the project office, and widely exercise large scale prevention and control against plants pests plant pests and animals diseases animal diseases.
... See More + The pests prevention and control should cut the outbreak by more than 90 percent, the utilized dosage of pesticides by over 30 percent, and the usage of chemical drugs in the core green exemplary demonstration areas by above 50 percent. We hope the average mortality of sheep and beef cattle can be lowered by 2 percent and 4 percent respectively compared with the level prior to this project. The foot-and-mouth disease and parasites among other animals epidemics of sheep and beef cattle must also be effectively contained, with certain localities reaching purification standards. Such major zoonoses as Brucella should be substantially curbed, while the prevention capacity against imported epidemics must be significantly enhanced.
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The purpose of drafting this plan is to, through implementing the policy of prioritizing prevention and comprehensive control, to set up ten to twenty exemplary demonstration bases, introduce the conception of integrated pest management (IPM), offer IPM technique technologies trainings for farmers, grass-roots agricultural technique technologies cohorts and staff from the project office, and widely exercise large scale prevention and control against plants pests plant pests and animals diseases animal diseases.
... See More + The pests prevention and control should cut the outbreak by more than 90 percent, the utilized dosage of pesticides by over 30 percent, and the usage of chemical drugs in the core green exemplary demonstration areas by above 50 percent. We hope the average mortality of sheep and beef cattle can be lowered by 2 percent and 4 percent respectively compared with the level prior to this project. The foot-and-mouth disease and parasites among other animals epidemics of sheep and beef cattle must also be effectively contained, with certain localities reaching purification standards. Such major zoonoses as Brucella should be substantially curbed, while the prevention capacity against imported epidemics must be significantly enhanced.
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