MAXIMIZING POSITIVE SYNERGIES - World Health Organization

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References [1] Human Development Reports: Georgia. New York, United Nations Development Programme, 2008 (http://hdrstats.undp.org/en/2008/countries/country_fact_sheets/cty_fs_GEO.html, accessed 19 March 2009). [2] Georgia – Summary of Joint Needs Assessment. Findings prepared for the donor conference, Brussels, October 22, 2008. United Nations & World Bank, European Bank for Reconstruction and Development, European Commission, European Investment Bank, International Finance Corporation (http://siteresources.worldbank.org/INTGEORGIA/Resources/301645- 1224598099977/summary.pdf, accessed 19 Mar 2009) [3] A. Telyukov MP, G. Gotsadze, and L. Jugeli. 2003. Situation Analysis for a New Strategy of Technical Assistance in the Health Care Sector of Georgia. Bethesda, MD: The PHRplus Project, Abt Associates, Inc. [4] Gotsadze G, Zoidze A, Vasadze O. Reform strategies in Georgia and their impact on health care provision in rural areas: evidence from a household survey. Social Science & Medicine. 2005;60:809- 821. [5] Georgia Primary Health Care Development Project. Washington, DC: The World Bank, 2002 (http://web.worldbank.org/external/projects/main?pagePK=64283627&piPK=73230&theSitePK=4 0941&menuPK=228424&Projectid=P040555, accessed 3 Mar 2009) [6] Country Cooperation Strategy at a glance: Georgia. Geneva, World Health Organization, 2007 (http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_geo_en.pdf, accessed 19 Mar 2009). [7] Georgia National Health Account. Geneva, World Health Organization, 2008 (http://www.who.int/nha/country/geo.pdf, accessed on 19 Mar 2009) [8] WHO Statistical Information System (WHOSIS) [online database]. Geneva, World Bank. 19 Mar 2009. [9] World Development Indicators (WDI) Online[online database]. Washington, DC: World Bank. 19 Mar 2009. [10] Georgia at a glance. Washington, DC: The World Bank Group, 2008 (http://devdata.worldbank.org/AAG/geo_aag.pdf. , accessed 19 Mar 2009). [11] Curatio International Foundation. Effects of GFATM on Georgia's Health System Development 2008 (www.curatiofoundation.org, accessed 19 February 2009). [12] Curatio International Foundation. Final report of the System Wide Effects of Fund (SWEF) Study in Georgia (www.curatiofoundation.org, accessed 19 February 2009). [13] Bennett S, Fairbank A, 2003. The System-Wide Effects of The Global Fund To Fight AIDS, Tuberculosis and Malaria: A Conceptual Framework. Technical Report No. 031. Bethesda, MD: The Partners for Health Reformplus Project, Abt Associates Inc. 64
Ghana: Interactions between Health Systems and Global Fund supported TB and HIV programmes Abstract: Sai Pothapregada, Rifat Atun * Ghana, a beneficiary of support from the Heavily Indebted Poor Country Initiative, aims to achieve middle-income country status by 2015, supported by sustained economic growth and an articulated health policy goal of ‘Creating Wealth Through Health’. The country has benefited from large inflows of external resources accounting for nearly 22% of total health expenditure in 2006. The Global Fund contributes to more than 85% of the National AIDS Control Programme budget and 95% of funding for the Tuberculosis programme. This external support has been universally acknowledged as critical for rapid scale-up of disease-specific interventions. The existing mechanism for donor coordination and tracking earmarked funds under the Sector Wide Strategic Approach (SWAp) facilitated seamless integration of Global Fund programmes into existing structures, in line with the national health sector plan. The Global Fund projects have contributed to strengthening service delivery, availability of anti-TB/antiretrovirals (ARVs) and capacity building training for the workforce. These projects, however, do not often address other systemic challenges like institutional density, workforce availability, and availability of essential drugs. Aligning the Country Coordinating Mechanism (CCM) into the national accountability framework, integrating parallel and often demanding reporting requirements, and exploring alternatives to the competitive proposal-based funding mechanism to ensure predictable funding, have all been identified as critical areas for deliberation and action. Background The Republic of Ghana is centrally located in West Africa and is bordered on the east by the Togolese Republic, on the north and northwest by Burkina Faso, and on the west by the Republic of Côte d’Ivoire. Ghana is home to 23.5 million people, and has experienced an average annual population growth of 2.2% since 2001[1]. Since 1997, Ghana’s economy has sustained an average real GDP growth of more than 5%, with a 6.3% growth in 2007 [1]. The government now explicitly aims to achieve middle-income status by 2015 and is well ahead of schedule in achieving the key poverty-related Millennium Development Goals (MDGs). However, Ghana has not shown similar progress on its human development indicators – it ranked 142 out of 179 countries on the UN Human Development Index in 2006 [2]. Health care is provided by a multitude of players. The Ministry of Health (MOH), which is represented by the Ghana Health Service and teaching hospitals, owns approximately 49% of total health facilities. The private sector owns approximately 21%. Christian Health Association of Ghana (CHAG) institutions own 8% while private maternity homes own approximately 17%. .Distribution of health facilities and staff favours the affluent regions in south Ghana. It is estimated that more than 70% of the population rely on traditional medicine, even though this has not yet been adequately integrated into the formal health sector [3]. 65
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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
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
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 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 104 and 105: Background The Republic of Kenya li
Page 106 and 107: Results Leadership and Governance D
Page 108 and 109: Informants noted that a general lac
Page 110 and 111: time periods. Informants believed t
Page 114 and 115: 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
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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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References [1] The World Bank Group
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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
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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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References [1] The World Bank Group
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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
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Annex 02: Contributing Institutions
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