MAXIMIZING POSITIVE SYNERGIES - World Health Organization

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Despite these problems, GHI funding has helped vastly expand access to life‐saving ARV treatment for thousands in South Africa. Of the total estimated number of people in need of treatment, 55% were enrolled in the ART programme by the end of 2007 [25]. In addition, a steady increase in the amount of health funding from both government and donors for malaria has led to a drastic reduction in malaria incidence rates in the highest risk areas of South Africa. The cooperative approach adopted by South Africa, Swaziland and Mozambique has reduced overall incidence rates by more than 85% in the region [20]. Though South Africa has one of the most comprehensive private health sectors in the region, its public health sector caters for 80% of the population and faces a number of challenges [17]. The issue of equity in health care hence remains a challenge in South Africa. The inclusion of GHIs and donors in government strategic planning could increase their ability to provide complementary projects that strengthen comprehensive health services in poorly resourced areas while avoiding the potential pitfalls of budget support. Our study concluded that, effectively utilized, donor and GHI funding can provide a means of improving equity in access to health care for all South Africans. 178
References [1] The World Bank Group. South Africa at a glance. Washington, DC, World Bank, 2008 (http://devdata.worldbank.org/AAG/zaf_aag.pdf; accessed 19 May 2009). [2] United Nations Development Programme. Human Development Reports: South Africa. New York, UNDP, 2008 (http://hdrstats.undp.org/en/2008/countries/country_fact_sheets/cty_fs_ZAF.html; accessed 19 May). [3] Department of Health, Medical Research Council, OcrMacro. South Africa Demographic and Health Survey 2003. Pretoria, Department of Health, 2007. [4] Kingdon G, Knight J. Unemployment in South Africa: a microeconomic approach. http://www.csae.ox.ac.uk/resprogs/usam/default.html; accessed 27 February 2009. [5] South African Institute of Race Relations. South Africa Survey 2007/2008. [6] AVERT. HIV and AIDS in South Africa (http://www.avert.org/aidssouthafrica.htm; accessed 27 February 2009). [7] World Health Organization. Global Tuberculosis Database (http://www.who.int/globalatlas/dataQuery/default.asp). [8] SouthAfrica.info. Health care in South Africa (http://www.southafrica.info/about/health/health.htm; accessed 27 February 2009). [9] McIntyre D, Garshong B, Mtei G, et al. Beyond fragmentation and towards universal coverage: insights from Ghana, South Africa and the United Republic of Tanzania. Bulletin of the World Health Organization. 2008;86:871-876. [10] Benatar S. Health Care Reform and the Crisis of HIV/AIDS in South Africa. New England Journal of Medicine. 2004(351):81-92. [11] OECD. 2006 Survey on Monitoring the Paris Declaration, South Africa. Paris, OECD, 2007. [12] The World Bank Group. World Development Indicators (WDI) Online. [13] Thorne S, Kirkham SR, O’Flyn-Maggie K. The Analytic Challenge in Interpretative description. International Journal on Qualitative Methods. 2005, 3:1-21. [14] Mayan MJ. An Introduction to Qualitative Methods; A training module for students and professionals. Alberta, International Institute for Qualitative Methods, 2001. [15] Dugger CW. Study Cites Toll of AIDS Policy in South Africa. New York Times. 25 November 2008. [16] South African Government. National Department of Health. 2009. [17] AIDSMark. Regional Lessons Learned: Southern Africa. Washington DC, PSI, 2007. [18] South African National Department of Health. Treasury Budget 2009. 179
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Table of Contents Key Acronyms Intr
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Policy analysis of the impact of Gl
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OIs Opportunistic infections OVC Or
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core section of the document then p
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Figure 1: Analytic framework for MP
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studies. MPS researchers have linke
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Burundi: Building a health system t
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at between US$ 14.5 and US$ 18.5 pe
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collaborations with European school
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epresent only US$ 1.75 per month pe
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Service Delivery The decentralizati
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Long term HSS will require governme
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Cameroon: Evaluation of the Nationa
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Table 1 Basic Socioeconomic, Demogr
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of treatment interruptions (>two da
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side effects) were associated with
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Prevention behaviours Nearly half (
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References [1] The World Bank Group
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Out-of-pocket payments account for
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as well as the number of community
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Table 1: Characteristics of facilit
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Table 4: Estimated changes in human
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Central African Republic: Impact of
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Objectives and Methodology In this
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Financing There was a general appre
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NGOs and Civil Society The overall
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Discussion Interviews with key info
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China: The Impact of the Global Fun
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Table 2 Global Health Initiative In
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In Yunnan and Henan, the epidemic i
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funded only from the MOH Pilot Prog
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References [1] China at a glance. W
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1994, private spending and emergenc
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understanding of their roles and re
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References [1] Human Development Re
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In 2003, the government launched th
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Objectives and Methodology The data
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Health Workforce Ghana is challenge
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Discussion GHIs are critical for ra
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Haiti: Maximizing Positive Synergie
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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
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Much of the initial enthusiasm abou
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services, or for measures of qualit
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funds and more funding focused on i
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INDIA: Exploring how disease-specif
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PEPFAR* Year Amount Disbursed (in U
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Primary data collection - facility
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The Global Fund has strengthened th
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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
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time periods. Informants believed t
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A comprehensive, long-term reform o
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The effects of GHIs on the capacity
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their budget was comprised of Globa
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Quality of services The majority of
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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
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Discussion The findings of the Mala
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Pakistan: The impact of the Global
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international standards. The Under
Page 134 and 135: the US Centers for Disease Control
Page 136 and 137: Some negative effects are also attr
Page 138 and 139: 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
Page 146 and 147: without substantial emphasis on pre
Page 148 and 149: References [1] The World Bank Group
Page 150 and 151: Rwanda: The Impact of Global Health
Page 152 and 153: Rwanda was US$ 584.9 million in 200
Page 154 and 155: International Health Partnership, t
Page 156 and 157: PEPFAR’s funding practices were l
Page 158 and 159: medical staff to higher-paying admi
Page 160 and 161: 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
Page 170 and 171: 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
Page 178 and 179: of South Africa (GHI2, ND6). 26 Don
Page 180 and 181: NDOH to disburse external funds in
Page 182 and 183: The lack of effective monitoring an
Page 186 and 187: [19] The Global Fund for Aids Tuber
Page 188 and 189: Official Development Assistance (OD
Page 190 and 191: The study employed both purposive s
Page 192 and 193: Figure 1: Number of Clinicians at S
Page 194 and 195: There were very significant increas
Page 196 and 197: GHIs created an opportunity to cond
Page 198 and 199: Ukraine: Effects of the Global Fund
Page 200 and 201: GAVI (in US$) Disease Priority Amou
Page 202 and 203: government and nongovernmental prov
Page 204 and 205: • The introduction of new service
Page 206 and 207: References [1] Data are from the Mi
Page 208 and 209: The health system struggles with a
Page 210 and 211: Objectives and Methodology This stu
Page 212 and 213: Nonetheless, efforts to recruit and
Page 214 and 215: References [1] The World Bank Group
Page 216 and 217: average annual population growth of
Page 218 and 219: 2006 149,022,153 2007 216,012,780 2
Page 220 and 221: isks duplication of services but al
Page 222 and 223: centres have only one qualified hea
Page 224 and 225: Policy analysis of the impact of Gl
Page 226 and 227: countries” [6]. The TRP apply sev
Page 228 and 229: PEPFAR I & II The newest PEPFAR leg
Page 230 and 231: 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
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HRH Intervention Categories GLOBAL
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HRH Intervention Categories PEPFAR
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Conclusion: Directions for future r
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GHIs and health systems. Civil soci
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Annex 01: Data sources for tables i
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Annex 02: Contributing Institutions
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