MAXIMIZING POSITIVE SYNERGIES - World Health Organization

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Policy analysis of the impact of Global Health Initiatives on health systems: 218 policies and lessons learned from donor programmes Anne Rossier Markus, Seble Frehywot, Amie Heap, Alan Greenberg Conclusion Directions for future research on positive synergies 236 Annex 01 Data sources for tables in country case studies 240 Annex 02 Contributing Institutions 242 The named contributors alone are responsible for the views expressed in this publication.
Key Acronyms 1 AIDS (SIDA) Acquired immunodeficiency syndrome ANC Antenatal care ART Antiretroviral therapy ARVs Antiretrovirals CBO Community-based organization CCM Country coordinating mechanism CDC U.S. Center for Disease control CHW Community health worker CSO Civil society organization DFID U.K. Department for International Development DOTS Directly Observed Treatment, short-course FBO Faith-based organization GAVI Global Alliance for Vaccines and Immunization GHI Global health initiative Global Fund Global Fund to fight AIDS, Tuberculosis and Malaria GDP Gross domestic product HIPC Initiative Heavily Indebted Poor Countries Initiative HIV Human immunodeficiency virus HMIS Health management information system IDU Injecting drug user ILO International Labour Organization M&E Monitoring and evaluation MDG Millennium Development Goal MDR-TB Multidrug-resistant tuberculosis MOH Ministry of Health MPS Maximizing Positive Synergies NACP National AIDS Control Programme NGO Nongovernmental organization ODA Official Development Assistance 1 All other abbreviations are spelled out in full in individual country case studies.
Page 2 and 3: Table of Contents Key Acronyms Intr
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
Page 94 and 95:
INDIA: Exploring how disease-specif
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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
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time periods. Informants believed t
Page 112 and 113:
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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
Page 126 and 127:
Objectives and methodology The main
Page 128 and 129:
Discussion The findings of the Mala
Page 130 and 131:
Pakistan: The impact of the Global
Page 132 and 133:
international standards. The Under
Page 134 and 135:
the US Centers for Disease Control
Page 136 and 137:
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:
Page 144 and 145:
HIV/AIDS, mainly around the Compreh
Page 146 and 147:
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
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:
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 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:
Page 216 and 217:
average annual population growth of
Page 218 and 219:
2006 149,022,153 2007 216,012,780 2
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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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