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How are countries in the Western Pacific Region tracking the HIV epidemic? Results from a 2011 survey of ministries of health

Yu, Dongbao; Wi, Teodora; Calleja, Jesus Garcia
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica
Publicado em 23/08/2013 EN
Relevância na Pesquisa
75.79%
In 2011, as part of the World Health Organization global reporting tool to collect data on the progress of improving the health sector response to HIV/AIDS towards universal access, a questionnaire was sent to ministries of health of Western Pacific Region Member States on the scope and functioning of their HIV surveillance systems. Of the 17 countries that responded, 13 were low- to middle-income countries and four were high-income countries. Regular serosurveillance surveys are conducted with female sex workers in all lower- and middle-income countries that responded to the survey but less so with people who inject drugs and men who have sex with men. Furthermore, there are no surveillance activities of the key populations in most of the Pacific island countries. It is recommended that estimations of high-risk populations be conducted in priority Pacific island countries and tailored surveillance systems be designed. Efforts should also be made to gather and accumulate data from sufficient geographic coverage to allow the HIV epidemic to continue to be monitored.

Governance in the Health Sector : A Strategy for Measuring Determinants and Performance

Savedoff, William D.
Fonte: Banco Mundial Publicador: Banco Mundial
Relevância na Pesquisa
65.69%
Many different strategies have been proposed to improve the delivery of health care services, from capacity building to establishing new payment mechanisms. Recent attention has also asked whether improvements in the way health care services are governed could make a difference. These approaches ask which factors -- such as rules and institutions -- influence the behavior of the system in ways that are associated with better performance and outcomes. This paper reviews the concept of governance as it is used in the literature on private firms, public administration, international development and health. It distinguishes between indicators that measure governance determinants from those that measure governance performance in order to propose a framework that is analytically coherent and empirically useful. The framework shows how these indicators can be used to test hypotheses about which governance forms are more useful for improving health system performance. The paper concludes by proposing specific measures of governance determinants and performance and describes the instruments available to collect and interpret them.

Performance-Based Contracting for Health Services in Developing Countries : A Toolkit

Loevinsohn, Benjamin
Fonte: Washington, DC : World Bank Publicador: Washington, DC : World Bank
EN_US
Relevância na Pesquisa
65.69%
This toolkit provides practical advice to anyone involved in, or who is interested in becoming involved in, performance-based contracting of health services with non state providers in the context of developing countries. It addresses many of the issues that may be encountered. Input from experienced contracting professionals will give newcomers increased confidence as they go forward. Experts directly involved in contracting on a large scale have contributed to the development of this toolkit. The first section provides summary before moving on to the main part of the toolkit. The section provides background on contracting, including definitions of key terms, the types of services that can be contracted, how contracting relates to other ways of organizing health services, and which contracting approaches work in different settings. The third section provides a systematic way of thinking about contracting and how to do it in practice. It looks at seven aspects of the contracting process from initial dialogue with stakeholders through carrying out the bidding process and managing contracts. This framework will help ensure a systematic consideration of the choices and challenges. The fourth section provides checklist which contains tasks and issues to address while designing and implementing a contract. The checklist can also be used to review an existing contract to see what is missing or could be improved. The fifth and final section reviews the evidence for contracting in developing countries...

Key Issues in Central America Health Reforms : Diagnosis and Strategic Implications, Volume 1. Synthesis of Findings

World Bank
Fonte: Washington, DC Publicador: Washington, DC
EN_US
Relevância na Pesquisa
65.84%
The main objective of this report is to identify and analyze the most pressing health sector issues in the sub region of El Salvador, Guatemala, Honduras, and Nicaragua (referred to as CA4) while building on the successes already attained, in order to lay the groundwork for discussing and refining strategies and policies in CA4. It will focus on analyzing (a) CA4 health sector performance, measured by financial protection and a subset of health indicators; and (b) health system functions of financing and service delivery. The report also addresses three topics that CA4 stakeholders selected as their main areas of interest: (a) decentralization processes initiated in these countries; (b) the design and implementation of alternative strategies to improve access to basic maternal and child health care services: and (c) the high prevalence of malnutrition. The synthesis of findings can be found in volume 1 of the report. In volume 2, aside from the introduction, the report comprises five chapters: Chapter 2 discusses the different aspects that characterize the health sector of these countries: health care financing...

Human Resources for Health Policies : A Critical Component in Health Policies

Dussault, Gilles; Dubois, Carl-Ardy
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
65.84%
In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources. Current approaches in human resources suggest a number of weaknesses: a reactive, ad hoc attitude towards problems of human resources; dispersal of accountability within human resources management (HRM); a limited notion of personnel administration that fails to encompass all aspects of HRM; and finally the short-term perspective of HRM. There are three broad arguments for modernizing the ways in which human resources for health are managed: a) the central role of the workforce in the health sector; b) the various challenges thrown up by health system reforms; and c) the need to anticipate the effect on the health workforce (and consequently on service provision) arising from various macroscopic social trends impinging on health systems. The absence of appropriate human resources policies is responsible...

Selecting Health Care Providers

Baeza, Cristian; Montenegro Torres, Fernando
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
65.84%
A strategic purchaser seeks to achieve the necessary correspondence between the needed health care services and goods (interventions) and the providers. In order to achieve this matching it is important to define with precision and in great detail what are the interventions needed to achieve in the most efficient way the goals of the purchaser before entering in the contracting process. The greater the complexity of the intervention the greater the need to contract with integrated delivery systems and not with individual providers. In the absence of integrated delivery systems, purchasers can provide the coordination of services and other related managerial activities in order to offer a continuum of care to the target population. However, this hands on approach is a heavy burden for purchasers and ideally this approach should be only transitory in order to focus on monitoring outcomes rather than micro-managing the provision of health care services.

Prevention of Health Risk Factors in Latin America and the Caribbean : Governance of Five Multisectoral Efforts

Bonilla-Chacin, Maria Eugenia
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
65.84%
Non-communicable diseases (NCDs) represent an important and growing burden to the health and economies of the Latin America and the Caribbean (LAC) region. However, some of this burden can be prevented or controlled through targeted clinical services and multi-sectoral activities aimed at improving diet, promoting physical activity, and reducing tobacco use and alcohol abuse. This study focuses on population-wide, multi-sectoral interventions to prevent risk factors for NCDs. This study seeks to answer the following questions: what is the health and economic burden of NCDs in the region?; what are countries doing to promote healthy living and prevent risk factors for NCDs?; what are the main governance challenges countries face in developing and implementing population-wide NCD prevention interventions and which are the success stories?; and what else can the region do to reduce health risk factors and prevent the onset of NCDs? This study documents governance challenges in the design and implementation of promising or successful population-wide interventions intended to prevent health risk factors in LAC. It focuses on the process whereby public officials develop and implement primary-prevention policies and programs. It is composed of five commissioned case studies on multi-sectoral interventions to promote healthy living in the region. These case studies examine which stakeholders participated directly or indirectly in the decision-making process; what positions they held; which incentives they faced; which strategies they pursued; how did existing institutional arrangements affect the decision-making process; what lessons can be drawn from these processes; and what were the successes and setbacks? This report provides a glimpse into the types of opposing interests and power games involved in proposing...

Immunization Finance Toolkit : A Resource for Policy-Makers and Program Managers

World Bank; GAVI Alliance
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
65.84%
Financing is a critical component of a sustainable Immunization program. The Immunization Financing Toolkit is a series of short briefs on different options for financing national immunization programs and vaccines. It is intended to serve as a resource for program managers and decision---makers in ministries of health, planning, and finance. The Toolkit brings together the most up---to---date knowledge on the characteristics of various types of= financing mechanisms as well as information on how the mechanisms are being implemented in practice, their potential benefits, and their limitations. Where possible, case studies on specific financing options are included. The field of immunization financing continues to evolve and the Toolkit will therefore be web---based and easily downloaded from the internet. As a web---based tool, the Toolkit contains links to other relevant websites for further understanding. The Toolkit is also available on a CD Rom. This version of the Toolkit is an update of the Immunization Financing Options produced by the Global Alliance for Vaccines and Immunization (GAVI Alliance) in 2001. Health sector funding and management have evolved over the last decade...

Healthy Partnerships : How Governments Can Engage the Private Sector to Improve Health in Africa

International Finance Corporation
Fonte: World Bank Publicador: World Bank
Tipo: Publications & Research :: Publication; Publications & Research :: Publication
ENGLISH
Relevância na Pesquisa
75.84%
Health systems across Africa are in urgent need of improvement. The public sector should not be expected to shoulder the burden of directly providing the needed services alone, nor can it, given the current realities of African health systems. Therefore to achieve necessary improvements, governments will need to rely more heavily on the private health sector. Indeed, private providers already play a significant role in the health sector in Africa and are expected to continue to play a key role, and private providers serve all income levels across sub- Saharan Africa's health systems. The World Health Organization (WHO) and others have identified improvements in the way governments interact with and make use of their private health sectors as one of the key ingredients to health systems improvements. Across the African region, many ministries of health are actively seeking to increase the contributions of the private health sector. However, relatively little is known about the details of engagement; that is...

Reducing Geographical Imbalances of Health Workers in Sub-Saharan Africa : A Labor Market Perspective on What Works, What Does Not, and Why

Lemiere, Christophe; Herbst, Christopher H.; Jahanshahi, Negda; Smith, Ellen; Soucat, Agnes
Fonte: World Bank Publicador: World Bank
Tipo: Publications & Research :: Publication; Publications & Research :: Publication
ENGLISH
Relevância na Pesquisa
75.69%
This report discusses and analyzes labor market dynamics and outcomes (including unemployment, worker shortages, and urban-rural imbalances of categories of health workers) from a labor economics perspective. It then uses insights from this perspective as a basis for elaborating policy options that incorporate the underlying labor market forces. The goal of the study is to address undesirable outcomes (including urban-rural HRH imbalances) more effectively. The study draws on an extensive inventory of policy options relevant to urban-rural labor force imbalance in Sub-Saharan Africa and the experiences with these imbalances to date. Given the limited documentation available on this topic through formal channels, the review relies heavily on 'gray literature' from policymakers in Sub-Saharan Africa and their development partners, especially the World Bank and the World Health Organization (WHO). The report is divided into five main sections. The first section focuses on economic policies related to Human Resources for Health (HRH) objectives. It argues that policymaking has ignored health labor market dynamics. The second section provides data showing the extent of urban-rural imbalances and describes how these imbalances affect health system outcomes. The third section uses a health labor market framework to explain these imbalances. The fourth section outlines policy options relevant to Sub-Saharan Africa for addressing market distortions and affecting labor market outcomes. It also reviews evidence on the policies...

Improving Effectiveness and Outcomes for the Poor in Health, Nutrition, and Population : An Evaluation of World Bank Group Support since 1997

Independent Evaluation Group
Fonte: Washington, DC: World Bank Publicador: Washington, DC: World Bank
Tipo: Publications & Research :: Publication; Publications & Research :: Publication
ENGLISH
Relevância na Pesquisa
65.92%
This evaluation aims to inform the implementation of the most recent the World Bank and International Finance Corporation (IFC) health, nutrition, and population (HNP) strategies to enhance the effectiveness of future support. It covers the period since fiscal year 1997 and is based on desk reviews of the portfolio, background studies, and field visits. The evaluation of the HNP support of the World Bank focuses on the effectiveness of policy dialogue, analytic work, and lending at the country level, while that of IFC focuses on the performance of health investments and advisory services before and after its 2002 health strategy. The themes it covers are drawn from the two strategies and the approaches adopted by international donors in the past decade. Independent Evaluation Group (IEG) has previously evaluated several aspects of the Bank's HNP support. IFC's support for the health sector has never been fully evaluated. Many lessons have been learned over the past decade about the successes and pitfalls of support for health reform: First...

Argentina - Increasing Utilization of Health Care Services among the Uninsured Population : The Plan Nacer Program

Cortez, Rafael; Romero, Daniela
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper; Publications & Research
EN_US
Relevância na Pesquisa
75.84%
This paper describes the functioning and performance of Argentina's Provincial Maternal and Child Health Investment Program, commonly referred to as Plan Nacer. The program is aimed at increasing access - for uninsured pregnant women and children under six years old - to a basic set of health services known to effectively address the main causes of maternal and child mortality, while improving the effectiveness and efficiency of the health system. The program supports the development and implementation of publicly funded provincial maternal and child health insurance and the introduction of highly innovative results-based financing mechanisms at the national, provincial, and provider levels. This document is organized as follows. Section 2 provides an overview of the Argentine health care system, including a description of public health, primary care, and supply-side efforts, to put in context the implementation of Plan Nacer. Section 3 presents a detailed description of the main features of the program, including the institutional architecture; the targeting, identification, and enrolment of beneficiaries; the management of the program's funds and benefits package; and the information environment of Plan Nacer. Section 4 provides a discussion of the highly innovative results-based financing mechanisms included in the design of the program. Section 5 draws some conclusions on the pending agenda and challenges ahead.

Improving Governance and Management of Health Systems : Partnerships and Observatories in Latin America and the Caribbean

Cortez, Rafael; Ferl, Katharina
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Brief; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
65.85%
Public health observatories proactively investigate health issues to provide robust analytical evidence to policy makers. This type of organization has different characteristics from other public health institutions, such as information-gathering bodies, academic public health departments, or state employed public health practitioners. Governments in Latin America have also begun establishing regional, national, and provincial observatories. Some of the regional observatories provide comparisons of countries in the region in areas such as public health, human resources, food security, and nutrition. Regional and national health observatories have become important tools for governments and health ministries to support national strategic partnerships and to empower civil society, health sector stakeholders, and health sector authorities seeking to develop more effective and efficient health systems. Health observatories are therefore a key instrument for health systems to generate information, data, and intelligence on people's health status and the type and quality of health care delivery. By making all this information available to health providers and policy makers in a timely manner...

Mainstreaming Gender in the Health Sector : Prevention of Gender-Based Violence and Male Involvement in Reproductive Health; Integracion de los asuntos de genero al sector salud : prevencion de la violencia por genero y participacion de los hombres en la salud reproductiva

Betron, Myra; Fort, Lucía
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Brief; Publications & Research
ENGLISH
Relevância na Pesquisa
65.84%
The Bank has hosted various conferences to address issues of male involvement in reproductive health and gender-based violence, yet no projects in the World Bank's portfolio have directly addressed either topic.1 Recent gender-related work in the World Bank's health projects in Latin America has made evident the limited capacity of health personnel and communities to integrate men into family planning and reproductive health programs or to respond effectively to domestic violence cases.2 Midwives at women's birthing centers in Nicaragua, for example, have been challenged with trying to convince men who oppose family planning of the economic difficulties of raising large families.3 Moreover, sheer lack of knowledge and capacity prevents health providers from screening for and providing proper treatment to gender-based violence survivors. The Integral Health Project for Men and Women, or PROSALVAR as it is commonly known, was designed to help build a response to these apparent gaps in healthcare projects in the LCR through pilot activities in three Highly Indebted Poor Countries: Bolivia...

ALICE2 Caso de estudio 7 Telesalud

Fonte: RedCLARA Publicador: RedCLARA
Tipo: Newspaper Formato: PDF
SPA
Relevância na Pesquisa
65.74%
Information on participation RedCLARA for Telehealth building as a support tool for Latin American Ministries of Health.; Información sobre participación de RedCLARA para la creación de Telesalud como herramienta de apoyo a los Ministerios de Salud Latinoamericanos.; ALICE2

Estudo de Caso ALICE2 7 - Telessaúde: Um caminho que a América Latina está decidida a asfaltar

Fonte: RedCLARA Publicador: RedCLARA
Tipo: Relatório Formato: PDF
POR
Relevância na Pesquisa
65.74%
Information on participation RedCLARA for Telehealth building as a support tool for Latin American Ministries of Health.; Na base da bem-sucedida experiência brasileira da RUTE –Rede Universitária de Telemedicina– e graças às poderosas comunicações, portanto, à integração que possibilitam as capacidades das Redes Nacionais de Pesquisa e Educação (RNIE) individuais e coletivas, mediante sua interconexão por meio da RedCLARA, na América Latina e o Caribe começa um caminho pela saúde dos seus habitantes onde o esboço de protocolos regionais de políticas públicas para Telessaúde será a chave da vitória.

ALICE2 Case Study 7 - Telehealth: A road which Latin America is determined to pave

Fonte: RedCLARA Publicador: RedCLARA
Tipo: Relatório Formato: PDF
ENG
Relevância na Pesquisa
65.74%
Information on participation RedCLARA for Telehealth building as a support tool for Latin American Ministries of Health.

Through Mintzberg's glasses: a fresh look at the organization of ministries of health.

Unger, J. P.; Macq, J.; Bredo, F.; Boelaert, M.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica
Publicado em //2000 EN
Relevância na Pesquisa
75.89%
In 1987, district health care policies were officially adopted by a majority of developing countries. Many operational problems constraining implementation of such policies have subsequently been identified, most of which are attributable to well-known characteristics of less developed countries. However, the policy of operational and administrative decentralization has often been critically obstructed by inappropriate organizational structures in ministries of health. By applying Mintzberg's analytical framework to several ministries of health, we identify structural deficiencies that make systems unfit to match their policy environment and yield the expected outcomes of functional and decentralized services. We propose a typology likely to elicit strategies for decentralizing health care administration. Our analysis is based on the following steps: a description of Mintzberg's concepts of organizational structure, generic components (strategic apex, technostructure, supporting structure, middle line, operational core) and functions (horizontal and vertical integration, liaison devices, vertical and horizontal decentralization) applied to health systems; a discussion of divisionalized adhocracy as a suitable configuration for health organizations with a need for a high degree of regional autonomy...

Through Mintzberg’s glasses: a fresh look at the organization of ministries of health

Unger,Jean-Pierre; Macq,Jean; Bredo,François; Boelaert,Marleen
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2000 EN
Relevância na Pesquisa
85.9%
In 1987, district health care policies were officially adopted by a majority of developing countries. Many operational problems constraining implementation of such policies have subsequently been identified, most of which are attributable to well-known characteristics of less developed countries. However, the policy of operational and administrative decentralization has often been critically obstructed by inappropriate organizational structures in ministries of health. By applying Mintzberg’s analytical framework to several ministries of health, we identify structural deficiencies that make systems unfit to match their policy environment and yield the expected outcomes of functional and decentralized services. We propose a typology likely to elicit strategies for decentralizing health care administration. Our analysis is based on the following steps: - a description of Mintzberg’s concepts of organizational structure, generic components (strategic apex, technostructure, supporting structure, middle line, operational core) and functions (horizontal and vertical integration, liaison devices, vertical and horizontal decentralization) applied to health systems; - a discussion of divisionalized adhocracy as a suitable configuration for health organizations with a need for a high degree of regional autonomy...

Surveillance for leptospirosis in the Americas, 1996-2005: a review of data from ministries of health

Costa,Federico; Martinez-Silveira,Martha Silvia; Hagan,José E.; Hartskeerl,Rudy A.; Reis,Mitermayer Galvão dos; Ko,Albert Icksang
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2012 EN
Relevância na Pesquisa
65.72%
OBJECTIVE: To characterize current leptospirosis reporting practices in the Americas. METHODS: Information was collected from the official websites of national ministries of health from the Americas region and two international organizations; personal communications; and three international morbidity databases. For all sources other than the morbidity databases, the review was limited to official reports citing clinically suspected and laboratory confirmed leptospirosis cases or deaths during the period 1996-2005. RESULTS: A total of 73 out of 1 644 reports met the selection criteria and were included in the analysis. Published leptospirosis data were available from half of the countries/sovereign territories (24 out of 48), and 18 of them had mandatory notification policies for leptospirosis. The sum of the median number of leptospirosis cases notified annually by the 24 countries/territories was 4 713.5, but just three countries (Brazil, Costa Rica, and Cuba) accounted for 83.1% (3 9cas20 es) of the notifications. Eight (16.7%) countries reported deaths due to leptospirosis. The sum of the median number of deaths reported annually for the eight countries was 380, but 349 (91.8%) were reported by Brazil. CONCLUSIONS: Notification practices in the Americas for leptospirosis are limited. Therefore...