MAXIMIZING POSITIVE SYNERGIES - World Health Organization

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Official Development Assistance (ODA) to Uganda in 2006 was US$ 1.55 billion [8]. The country’s total debt is 13.3% of gross domestic product (GDP) [1]. In 2006, The International Monetary Fund (IMF) and the World Bank’s International Development Association provided the country with debt relief of approximately US$4 billion, a reduction of about 90% [9]. Table 1 Basic Socioeconomic, Demographic and Health Indicators* * Full data sources for all indicators are provided in Annex 1 Indicator Value Year Source Population (thousands) 30,916 2007 World Bank Geographic Size (sq. km) 197,100 2007 World Bank GDP per capita, PPP (constant 2005 international $) 1000 2007 World Bank Gini index 43 2005 World Bank Government expenditure on health (% general government expenditure) 8.9 2007 WHO NHA Per capita government expenditure on health (current US$) 7 2007 WHO NHA Physician density (per 10,000)
PEPFAR Year Amount Disbursed (in US$) 2004 90,774,095 2005 148,435,327 2006 169,875,461 2007 236,626,415 2008 283,635,476 TOTAL: 929,346,774 GAVI Disease Priority Amount Approved (in US$) Pentavalent vaccine 175,310,000 Vaccine introduction grant 100,000 Injection Safety 1,385,000 Immunization services support 9,230,520 Health system strengthening 19,242,000 TOTAL: 205,267,157 World Bank MAP Title FY Approved/Closing Date Commitment (in US$) HIV/AIDS Control Project 2001/2006 47,500,000 Objectives and Methodology This evaluation study was designed to generate information that can inform health policy and programming from the knowledge, experience and perceptions of personnel at health facilities implementing GHI-funded programmes. Specific aims were: (1) To elicit perceptions about GHIs in Uganda; (2) to find out how GHIs have strengthened health systems in Uganda; (3) to establish how GHIs have interacted with health systems at different levels in Uganda; (4) to generate questions for further analysis and study within the health context in Uganda; (5) to identify knowledge and data gaps in the Ugandan context. The study was conducted in 23 districts selected from the four geo-political regions of Uganda. Research was conducted at 35 sites: Four regional (Provincial) referral hospitals, 11 district hospitals, three private sector hospitals, 15 Health Centre Grade IV facilities and two nongovernment health facilities. Eighty-two percent of the sites surveyed were operated by government; 9% by missionary organizations; and 9% by other nongovernment agencies. All participating agencies had implemented programmes funded by GHIs, especially Global Fund and PEPFAR. The study population comprised district health officers of the identified districts; medical superintendents heading identified hospitals; medical officers in charge of identified health centres; institution heads of identified private sector agencies; and opinion leaders identified and contacted during the study. 183
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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
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the US Centers for Disease Control
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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 184 and 185: Despite these problems, GHI funding
Page 186 and 187: [19] The Global Fund for Aids Tuber
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
Page 234 and 235: TABLE 3: Selected Countries: MPS Ca
Page 236 and 237: 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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