MAXIMIZING POSITIVE SYNERGIES - World Health Organization

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Table of Contents Key Acronyms Introduction The maximizing positive synergies project 1 and the purpose of this document Burundi Building a health system together with Global 8 Health Initiatives, in the aftermath of war Johann Cailhol, Thuba Mathole, Annie Parsons, David Sanders, Denise Kandondo, Innocent Ndayiragije and Théodore Niyongabo Cameroon Evaluation of the national programme for access 20 to antiretroviral therapy Boyer S., Eboko F., Camara M., Abé C., Owona Nguini M.E., Koulla-Shiro S., Moatti J-P. Cameroon Impact of Global Health Initiatives on primary level health 31 care facilities: the case of Kumba and Limbe health districts Peter M. Ndumbe, Julius Atashili Central African Impact of the Global Health Initiatives 40 Republic on the health system: perceptions of informants Julius Atashili, Marie-Claire Okomo, Emilia Lyonga, Nayana Dhavan, Nikita Carney, Erin Sullivan, Peter Ndumbe China Impact of the Global Fund HIV/AIDS programmes on 50 coordination and coverage of financial assistance schemes for people living with HIV/AIDS and their families Zhang Xiulan, Pierre Miège and Zhang Yurong Georgia System-wide effects of the Global Fund on Georgia’s 59 health care systems Ketevan Chkhatarashvili, George Gotsadze, Natia Rukhadze Ghana Interactions between health systems and Global Fund-supported 65 TB and HIV programmes Sai Pothapregada, Rifat Atun Haiti Maximizing positive synergies between Global Health 74 Initiatives and the health system LC Ivers, JG Jerome, E Sullivan, JR Talbot, N Dhavan, M StLouis, W Lambert, J Rhatigan, JS Mukherjee India Exploring how disease-specific programmes in TB and 88 HIV/AIDS interact with health systems Krishna Dipankar Rao, Mathew Sunil George, Aarushi Bhatnagar, Babita Rajkumari, Maulik Chokshi, Preeti Kumar and Indrajit Hazarika
Kenya The impact of Global Health Initiatives on the health system 97 Joseph Rhatigan, Erin Sullivan, Kileken ole-MoiYoi, George Kimathi, Nayana Dhavan, Ephantus Kabiru Kyrgyzstan Tracking global HIV/AIDS initiatives and their impact 107 on the health system Gulgun Murzalieva, Julia Aleshkina, Arnol Samiev, Neil Spicer, Gill Walt Malawi Global Health Initiatives and delivery of health care: 117 the case of the Global Fund Victor Mwapasa and John Kadzandira Pakistan Impact of the Global Polio Eradication Initiative on the 124 health system Sania Nishtar Peru Effects of the implementation of Global Fund-supported 134 HIV/AIDS projects on health systems, civil society and affected communities, 2004-2007 Carlos F. Cáceres, Maziel Girón, Clara Sandoval, Roberto López, José Pajuelo, Rocío Valverde, Patricia Vásquez, Alfonso Silva-Santisteban, Ana Maria Rosasco Rwanda Impact of Global Health Initiatives on the health system: 144 a mixed methods analysis Mukherjee JS, Jerome JG, Sullivan E, May MA, Mayfield A, Lambert W, Dhavan N, Carney N, Rhatigan J, Ivers LC Senegal Effects of Global Health Initiatives on the health system 160 Papa Salif Sow, Fatou Francesca Mbow, Aliou Diallo, Demba Dione, Marième Ba South Africa The effects of Global Health Initiative funding for HIV/AIDS 168 on the health system Thomas Bisika, Eric Buch, Thubelihle Mathole, Annie Parsons, David Sanders Uganda Expanding targeted services into primary health care 181 Dr. Bernard Michael Etukoit, Mr. Richard Wanyama Ukraine Effects of the Global Fund on the health system 192 Tetyana Semigina United Republic Strengthening the health system to address 201 of Tanzania the burden of HIV/AIDS and TB Thyra de Jongh, Rifat Atun Zambia Global HIV/AIDS initiatives and health system capacity to 209 cope with the scale-up of HIV services Phillimon Ndubani, Joseph Simbaya, Aisling Walsh, Ruairí Brugha
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 12 and 13: studies. MPS researchers have linke
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
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China: The Impact of the Global Fun
Page 58 and 59:
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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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
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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
Page 132 and 133:
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
Page 142 and 143:
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HIV/AIDS, mainly around the Compreh
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without substantial emphasis on pre
Page 148 and 149:
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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
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medical staff to higher-paying admi
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system (CPDS), in which many stakeh
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needing medical transport. Both GHI
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Some informants felt that local NGO
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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
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of respondents aware of treated net
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South Africa: The effects of Global
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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
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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
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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
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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
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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
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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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