MAXIMIZING POSITIVE SYNERGIES - World Health Organization

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Discussion Interviews with key informants in the CAR suggest that they perceive GHIs to be particularly important in the health system. GHIs are thought to have positively impacted the governance, financing, monitoring and evaluation, workforce, infrastructure and technology, and community participation in the health system. There was a perceived improvement in access to prevention and care of targeted diseases, with multiple treatments or vaccines being made free. In addition to these positive effects, there were a few negative spillover effects described; however, these were largely overwhelmed by the positive effects of GHIs. Quantitative data will be needed to confirm these perceptions. The recommendations by informants may be useful in maximizing the positive synergies between GHIs and the CAR’s health system. Acknowledgements We thank health officials in the Central African Republic who provided their perceptions. We also acknowledge writing and analysis assistance from the Global Health Delivery Project at the Harvard School of Public Health. We also thank the WHO country representative for CAR and staff for assistance in accessing study participants. 48
References [1] The World Bank Group. Central African Republic Data-at-a-Glance 2008. [2] United Nations Development Programme. Human Development Reports: Central African Republic 2008. [3] United Nations Office for the Coordination of Humanitarian Affairs. Central African Republic Humanitarian Country Profile. (http://www.irinnews.org/country.aspx?CountryCode=CFA&RegionCode=GL; Accessed 25 February 2009). [4] WHO Global Malaria Programme. World Malaria Report 2008. [5] World Health Organization. Central African Republic Summary Country Profile for HIV/AIDS Treatment Scale-Up 2005. [6] UNAIDS. 2008 Report on the Global AIDS Epidemic 2008. [7] Core Health Indicators: Central African Republic. World Health Organization Information System; 2008. [8] WHO. Global Tuberculosis Control: Surveillance, Planning, Financing 2008. [9] Humanitarian and Development Partnership Team Central African Republic. Health. (http://hdptcar.net/blog/health/; Accessed 25 February 2009). [10] The World Bank Group. World Development Indicators: Central African Republic; 2008. [11] International Monetary Fund and International Development Association. Central African Republic Joint World Bank/IMF Debt Sustainability Analysis 2008. [12] GFATM. Central African Republic and the Global Fund. (http://www.theglobalfund.org/programs/portfolio/?lang=e&countryID=CAF; Accessed 25 February 2009). 49
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Table of Contents Key Acronyms Intr
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 56 and 57: China: The Impact of the Global Fun
Page 58 and 59: Table 2 Global Health Initiative In
Page 60 and 61: In Yunnan and Henan, the epidemic i
Page 62 and 63: funded only from the MOH Pilot Prog
Page 64 and 65: References [1] China at a glance. W
Page 66 and 67: 1994, private spending and emergenc
Page 68 and 69: understanding of their roles and re
Page 70 and 71: References [1] Human Development Re
Page 72 and 73: In 2003, the government launched th
Page 74 and 75: Objectives and Methodology The data
Page 76 and 77: Health Workforce Ghana is challenge
Page 78 and 79: Discussion GHIs are critical for ra
Page 80 and 81: Haiti: Maximizing Positive Synergie
Page 82 and 83: Table 1 Basic Socioeconomic, Demogr
Page 84 and 85: with need. With GHI funding, distri
Page 86 and 87: I know that within [the organizatio
Page 88 and 89: Much of the initial enthusiasm abou
Page 90 and 91: services, or for measures of qualit
Page 92 and 93: funds and more funding focused on i
Page 94 and 95: INDIA: Exploring how disease-specif
Page 96 and 97: 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
Page 106 and 107:
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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References [1] The World Bank Group
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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
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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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Table 2 Global Health Initiative In
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of South Africa (GHI2, ND6). 26 Don
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NDOH to disburse external funds in
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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
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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
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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
Page 248 and 249:
Annex 02: Contributing Institutions
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