MAXIMIZING POSITIVE SYNERGIES - World Health Organization

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studies. MPS researchers have linked quantitative and qualitative methods for systematic triangulation of findings to strengthen results, provide richer evidence for conclusions, and build a more complete knowledge base that can inform policy and practice. Limitations of MPS research to date Country researchers contributing to MPS have worked to an aggressive timeline to produce initial results that can inform WHO normative guidance and policy debates within a critical window of political opportunity. As a consequence, analysis of the rich qualitative and quantitative data produced by MPS researchers is still ongoing. The findings presented in this report are preliminary. A notable limitation of the accelerated initial phase of MPS research is that it has focused heavily on PEPFAR and the Global Fund, with relatively little data collected on other GHIs. In subsequent phases of investigation, this imbalance will be corrected. The challenging MPS timeline has also meant that there has been limited opportunity to undertake cross-country analysis of findings— though important initial steps in this direction have occurred. Systematic cross-country comparative analysis will be a central component of the next phase of work on positive synergies. The case study model used by MPS researchers has advantages but also limitations. In the research by MPS collaborators, the case study approach has been constrained by factors impacting case selection: access to countries, resources, and available time. Case studies are less suited to proving causal pathways than to building and refining hypotheses about them based on informants’ experience and relevant documentation. In many countries, “longitudinal” case studies are anticipated; however, the case summaries presented in this document generally provide a picture of the situation at a particular point in time. They are most usefully construed as the initial phase of a long-term research collaboration. In general, MPS research to date has fulfilled a critical exploratory function. Providing rich descriptive data on GHI-health systems interactions in country contexts, it has traced directions for a subsequent phase of research that will formulate and test additional explanatory hypotheses to better understand the causal factors that enable or hinder positive synergies. 6
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Page 2 and 3: Table of Contents Key Acronyms Intr
Page 4 and 5: Policy analysis of the impact of Gl
Page 6 and 7: OIs Opportunistic infections OVC Or
Page 8 and 9: core section of the document then p
Page 10 and 11: Figure 1: Analytic framework for MP
Page 14 and 15: Burundi: Building a health system t
Page 16 and 17: at between US$ 14.5 and US$ 18.5 pe
Page 18 and 19: collaborations with European school
Page 20 and 21: epresent only US$ 1.75 per month pe
Page 22 and 23: Service Delivery The decentralizati
Page 24 and 25: Long term HSS will require governme
Page 26 and 27: Cameroon: Evaluation of the Nationa
Page 28 and 29: Table 1 Basic Socioeconomic, Demogr
Page 30 and 31: of treatment interruptions (>two da
Page 32 and 33: side effects) were associated with
Page 34 and 35: Prevention behaviours Nearly half (
Page 36 and 37: References [1] The World Bank Group
Page 38 and 39: Out-of-pocket payments account for
Page 40 and 41: as well as the number of community
Page 42 and 43: Table 1: Characteristics of facilit
Page 44 and 45: Table 4: Estimated changes in human
Page 46 and 47: Central African Republic: Impact of
Page 48 and 49: Objectives and Methodology In this
Page 50 and 51: Financing There was a general appre
Page 52 and 53: NGOs and Civil Society The overall
Page 54 and 55: Discussion Interviews with key info
Page 56 and 57: China: The Impact of the Global Fun
Page 58 and 59: Table 2 Global Health Initiative In
Page 60 and 61: In Yunnan and Henan, the epidemic i
Page 62 and 63:
funded only from the MOH Pilot Prog
Page 64 and 65:
References [1] China at a glance. W
Page 66 and 67:
1994, private spending and emergenc
Page 68 and 69:
understanding of their roles and re
Page 70 and 71:
References [1] Human Development Re
Page 72 and 73:
In 2003, the government launched th
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Objectives and Methodology The data
Page 76 and 77:
Health Workforce Ghana is challenge
Page 78 and 79:
Discussion GHIs are critical for ra
Page 80 and 81:
Haiti: Maximizing Positive Synergie
Page 82 and 83:
Table 1 Basic Socioeconomic, Demogr
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with need. With GHI funding, distri
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I know that within [the organizatio
Page 88 and 89:
Much of the initial enthusiasm abou
Page 90 and 91:
services, or for measures of qualit
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funds and more funding focused on i
Page 94 and 95:
INDIA: Exploring how disease-specif
Page 96 and 97:
PEPFAR* Year Amount Disbursed (in U
Page 98 and 99:
Primary data collection - facility
Page 100 and 101:
The Global Fund has strengthened th
Page 102 and 103:
References [1] The World Bank Group
Page 104 and 105:
Background The Republic of Kenya li
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Results Leadership and Governance D
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Informants noted that a general lac
Page 110 and 111:
time periods. Informants believed t
Page 112 and 113:
Page 114 and 115:
A comprehensive, long-term reform o
Page 116 and 117:
The effects of GHIs on the capacity
Page 118 and 119:
their budget was comprised of Globa
Page 120 and 121:
Quality of services The majority of
Page 122 and 123:
References [1] Kyrgyzstan at a glan
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Commission (NAC) in 2001 as a multi
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Objectives and methodology The main
Page 128 and 129:
Discussion The findings of the Mala
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Pakistan: The impact of the Global
Page 132 and 133:
international standards. The Under
Page 134 and 135:
the US Centers for Disease Control
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Some negative effects are also attr
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to country health systems by way of
Page 140 and 141:
Peru: Effects of the Implementation
Page 142 and 143:
Table 2 Global Health Initiative In
Page 144 and 145:
HIV/AIDS, mainly around the Compreh
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without substantial emphasis on pre
Page 148 and 149:
Page 150 and 151:
Rwanda: The Impact of Global Health
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Rwanda was US$ 584.9 million in 200
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International Health Partnership, t
Page 156 and 157:
PEPFAR’s funding practices were l
Page 158 and 159:
medical staff to higher-paying admi
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system (CPDS), in which many stakeh
Page 162 and 163:
needing medical transport. Both GHI
Page 164 and 165:
Some informants felt that local NGO
Page 166 and 167:
Senegal: The effects of Global Heal
Page 168 and 169:
Table 1: Basic Health System and Ep
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case study. Data analysis was condu
Page 172 and 173:
of respondents aware of treated net
Page 174 and 175:
South Africa: The effects of Global
Page 176 and 177:
Table 2 Global Health Initiative In
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of South Africa (GHI2, ND6). 26 Don
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NDOH to disburse external funds in
Page 182 and 183:
The lack of effective monitoring an
Page 184 and 185:
Despite these problems, GHI funding
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[19] The Global Fund for Aids Tuber
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Official Development Assistance (OD
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The study employed both purposive s
Page 192 and 193:
Figure 1: Number of Clinicians at S
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There were very significant increas
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GHIs created an opportunity to cond
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Ukraine: Effects of the Global Fund
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GAVI (in US$) Disease Priority Amou
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government and nongovernmental prov
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• The introduction of new service
Page 206 and 207:
References [1] Data are from the Mi
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The health system struggles with a
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Objectives and Methodology This stu
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Nonetheless, efforts to recruit and
Page 214 and 215:
Page 216 and 217:
average annual population growth of
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2006 149,022,153 2007 216,012,780 2
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isks duplication of services but al
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centres have only one qualified hea
Page 224 and 225:
Policy analysis of the impact of Gl
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countries” [6]. The TRP apply sev
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PEPFAR I & II The newest PEPFAR leg
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Types of fundable HRH interventions
Page 232 and 233:
Global Fund In two country applicat
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TABLE 3: Selected Countries: MPS Ca
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HRH Intervention Categories GAVI: C
Page 238 and 239:
HRH Intervention Categories GLOBAL
Page 240 and 241:
HRH Intervention Categories PEPFAR
Page 242 and 243:
Conclusion: Directions for future r
Page 244 and 245:
GHIs and health systems. Civil soci
Page 246 and 247:
Annex 01: Data sources for tables i
Page 248 and 249:
Annex 02: Contributing Institutions
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