MAXIMIZING POSITIVE SYNERGIES - World Health Organization

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The health system struggles with a severe shortage of health care workers, particularly in the rural parts of the country, and suffers from weak infrastructure. In mainland Tanzania, the public health sector (56%) is complemented by a private sector comprising private for-profit groups (14%), as well as non-governmental organizations (NGOs) and faith-based organizations (FBOs) (30%) [5]. In Zanzibar, most health facilities are publicly run. Traditional medicine remains an important part of Tanzanian rural life [5]. In recent years government expenditure on health has increased, reaching 13.3% by 2006, but this figure remains shy of the Abuja target of 15% [6]. As of 2006, external resources made up 45.4% of the total expenditure on health [6]. In 2002, 44.5% of physicians worked in urban areas, although only an estimated 23% of the population lived in cities [7]. In the meantime, the overall health budget has grown significantly, principally as a result of large amounts of official development assistance (ODA). In 2006, ODA was US$ 1.8 billion. Tanzania’s total external debt in the same period was US$ 4.2 billion, 29.9% of GDP [1,8]. 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) 40,432 2007 World Bank Geographic Size (sq. km) 885,800 2007 World Bank GDP per capita, PPP (constant 2005 international $) 1,140.96 2007 World Bank Gini index 34.62 2000 World Bank Government expenditure on health (% of general government expenditure) 13.7 2007 WHO NHA Per capita government expenditure on health (current US$) 11 2007 WHO NHA Physician density (per 10,000)
Table 2 Global Health Initiative Investments (*) Global Fund Round & Disease Priority Approved (in US$) Disbursed (in US$) Round 1, Malaria 78,079,834 48,139,110 Round 1, HIV/AIDS 5,400,000 4,647,000 Round 3, HIV/TB 83,466,904 54,798,490 Round 4, HIV/AIDS 283,092,248 181,090,483 Round 4, Malaria 76,086,764 75,086,764 Round 6, TB 16,498,948 15,173,156 Round 7, Malaria 20,707,304 5,161,417 Round 8, HIV/AIDS 121,144,902 0 Round 8, Malaria 111,289,909 0 TOTAL: 795,766,813 384,096,420 PEPFAR Year Amount Allocated (in US$) 2004 70,745,574 2005 108,778,095 2006 129,967,925 2007 205,482,327 2008 313,415,559 TOTAL: 828,389,480 GAVI Disease Priority Amount Approved (in US$) Tetravalent vaccine 26,378,000 Vaccine introduction grant 100,000 Injection Safety 1,494,600 Immunization services support 7,990,880 TOTAL: 39,891,230 World Bank MAP Project Title FY Approved/Closing Date Commitment (in US$) Multisectoral AIDS Project 2004/2009 70,000,000 203
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Table of Contents Key Acronyms Intr
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Policy analysis of the impact of Gl
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OIs Opportunistic infections OVC Or
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core section of the document then p
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Figure 1: Analytic framework for MP
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studies. MPS researchers have linke
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Burundi: Building a health system t
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at between US$ 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
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to country health systems by way of
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Peru: Effects of the Implementation
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Table 2 Global Health Initiative In
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HIV/AIDS, mainly around the Compreh
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without substantial emphasis on pre
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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
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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 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 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
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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MAXIMIZING POSITIVE SYNERGIES - World Health Organization

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