The Adamawa Primary Health Care System in Nigeria has implemented performance-based financing (PBF) to address underlying issues plaguing the health system. After two years of pre-pilot implementation, results have been encouraging with improvements in key indicators like institutional deliveries and vaccination rates. Success stories like Mayo-Ine health center demonstrate how community engagement and strengthened management can boost coverage. However, some indicators still show room for growth, and deeper analysis finds issues like staffing shortages and infrastructure problems influencing performance. Moving forward, continued scale-up and addressing broader health system challenges will be important to sustain gains under PBF in Adamawa State.
HMPRG Safety Net Initiative History- Lon BerkeleyHealthwork
PPT Setting the Stage for the Regional Health Care Safety Net in Northeastern Illinois. Presented at the Safety Net Summit, June 23, 2009, hosted by Health & Medicine Policy Research Group (HMPRG) and the U.S. Health Resources and Services Administration (HRSA)
Strengthening the Health Workforce to Improve Quality and Achieve Universal H...HFG Project
Universal health coverage (UHC) means anyone can access necessary, good quality health care without suffering financial hardship. A strong health workforce is crucial to achieving UHC, but poor quality pre-service training and governance often weaken the health workforce. In many countries, governments and families alike spend their limited funds on pre-service training institutions that graduate health workers with inadequate skills, which can result in poor patient care and poor health outcomes. Further, some governments do not provide strong stewardship of the health workforce, and miss critical opportunities to improve morale, retention, and skills.
This presentation focuses on three countries that are taking a systems approach to solving these two problems, with help from HFG: Haiti, Côte d’Ivoire, and Swaziland.
In Haiti, HFG is working with the Ministry of Health to bolster its process for accrediting nursing education institutions, known as reconnaissance. More than 40 schools have already received the new accreditation. The government of Côte D’Ivoire identified task-sharing between nurses/midwives and doctors for HIV care as a key strategy to improve HIV outcomes. HFG is supporting the Ministry of Health in developing policies and training programs on task-sharing to integrate into health worker training curricula. In Swaziland, HFG is working with the government to establish standardized hiring and compensation policies for health workers, and to strengthen human resource information systems. HFG also worked with the Swaziland Nursing Council to strengthen their capacity to regulate the nursing profession and expand nursing competencies to incorporate international best practices.
The Janani Suraksha Yojana (JSY) program provides cash assistance to promote institutional delivery among pregnant women. It aims to reduce maternal and infant mortality. The document outlines that JSY replaces an earlier program and is fully funded by the central government. It integrates cash payments with delivery and post-natal care. States are classified as Low or High Performing, and cash benefits differ based on these categories and place of delivery. The roles of ASHA workers and various administrative bodies in implementing JSY are also summarized.
This document outlines a project called Walgan Tilly - Aboriginal Specific Redesign which aims to improve chronic care for Aboriginal people in NSW. It discusses issues identified such as poor identification of Aboriginal patients and a lack of cultural awareness. The project involved stakeholder interviews and workshops to develop state-wide and local solutions. Key targets include improving Aboriginal identification, increasing participation in chronic disease programs, and follow up care within 48 hours of discharge. It emphasizes improving data quality and cultural sensitivity across the health system to better meet the needs of Aboriginal people with chronic conditions.
CORE Group Fall Meeting 2010. WHO/UNICEF - Joint Statement Service Delivery & Program Implications, - Winnie Mwebesa & Stella Abwao, Save the Children.
Localization of Universal Health Coverage for Equitable Health Outcomes in NepalDeepak Karki
Presentation entitled "Localization of Universal Health Coverage for Equitable Health Outcomes in Nepal" by Dr Shiva Raj Adhikari on the 18th Anniversary of Nepalt Health Economics Association.
This was my talk for the Kaya Natin-Ateneo School of Government Young Leaders for Health Conference. The participants are medical school students from all over the country. The goal of the 3 day conference is to encourage them to craft a public health initiative for their selected community for a competitive grant at the end of the 3rd day.
My session goal was to frame public health as an instrument in national development. But at the same time, I wanted them to see their initiatives as a sound public health development project.
This document outlines the process and goals of a regional health care safety net summit. It provides background on the initiative, including key terminology, assumptions, and demographic data of the region. It also summarizes ongoing efforts to strengthen the safety net and the Chicago Metropolitan Agency for Planning's GoTo 2040 plan, which includes recommendations to integrate health policy into regional planning. The document introduces preliminary recommendations that will be discussed at the summit to continue progressing the initiative.
The document summarizes NC Healthy Worksites past, present, and future efforts to promote worksite wellness in North Carolina. It discusses developing toolkits and providing technical assistance to worksites in the past. Currently, it focuses on statewide weight loss programs and forming a collaborative to promote comprehensive wellness programs. Looking ahead, it plans a branding campaign, sustainability plan, and business education events to support worksite wellness.
Essential Package of Health Services Country Snapshot: LiberiaHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
WHAT is the Ottawa County Community Health Improvement Plan?
A plan that focuses on the greatest health needs in Ottawa County. Community members, including people from health care and human service agencies, identified three priority health areas based on data from the Community Health Needs Assessment (CHNA).
WHY a CHIP?
Public health challenges are too great for a single person, organization or sector to solve alone. The CHIP is a guide for the community to work together and meet its health needs.
The document proposes a proof-of-concept and pilot program for an integrated women and child health program using a community outreach model in Gajwel constituency, Hyderabad. The program would address critical gaps in healthcare access and services through three dimensions: 1) segmentation of populations to reach socially and economically vulnerable groups, 2) redefining intervention areas and care services, and 3) a care services continuum of screening, identification, referral, enablement and follow-up. The pilot would focus on women aged 15+, children aged 5-15, pregnant women, and newborns, providing services across primary care, reproductive health, eye care, oral health and more. It would employ community health workers and leverage ICT platforms
The document discusses the health workforce crisis in sub-Saharan Africa. It notes that the region has 24% of the global disease burden but only 3% of health workers. 57 countries have severe shortages of doctors, nurses and midwives. The causes of the crisis include underfunding, HIV/AIDS, and brain drain. Solutions proposed include increasing training, management improvements, incentives, task-shifting, and global initiatives like PEPFAR to help address financing and workforce needs. Individual actions are suggested to support related legislation and policies.
This presentation provides an overview of the Affordable Care Act's Maternal, Infant, and Early Childhood Home Visiting Program. It discusses the program's legislative authority, goals of improving maternal and child health outcomes, priority populations, implementation of evidence-based home visiting models, status of program implementation across states, and opportunities the program provides. Evaluation of program impacts is being led by MDRC and partners through the Mother and Infant Home Visiting Project Evaluation.
Oyo State Global Fund HIV MARPs Progress Report June 2015 - December 2016John Bako
This presentation showcase GF HIV NFM progress report and data on HIV Prevention project among KAP in Oyo State between July 2015 – December 2016.
The intervention was conducted in some hotspots across Oyo state known to be the largest city in West Africa with a population of 7,554,750 (NPC 2015 projection).
Oyo is a South-Western state, created in February 3, 1976 with its capital in Ibadan.
The state has HIV prevalence rate of 5.6% (NARHS 2012).
Nr506 w7 policymaker_electronic_presentation_pp_dassVinitaRajiv Dass
The document discusses Senator Bernie Sanders' plan to strengthen the Social Security Program (SSP) by raising taxes on wealthy Americans. It summarizes a discussion with one of Sanders' staffers who outlined Sanders' 12-point initiative plan. This includes strengthening SSP and other social programs, raising the minimum wage, implementing universal healthcare, and enacting a more progressive tax system. The document advocates staying engaged in policy debates around SSP to help shape its future and ensure retirement security for generations to come.
Mona Sinha, UNICEF - A social movement to end child marriage and dowry in Bih...POSHAN
Presentation made at an IFPRI event on "What Lies Beneath:
Women’s and Girls’ Wellbeing as a Critical Underpinning of India’s Nutritional Challenge" on December 10, 2018, in New Delhi
The Janani Suraksha Yojana (JSY) program was launched in 2005 as a replacement for the National Maternity Benefit Scheme with the objectives of reducing maternal and infant mortality rates by encouraging institutional deliveries. It provides cash assistance integrated with antenatal and postnatal care, targeting women below the poverty line in both rural and urban areas. The cash benefits provided vary between low and high performing states. The Janani Shishu Suraksha Karyakram (JSSK) was introduced in 2011 to provide cashless delivery and newborn care services.
Universalizing access to quality primary healthcare in India faces several challenges. Social challenges include rigidity in villages and inclusion of communities which can be addressed through awareness campaigns. Economic challenges involve potential misuse of funds and insufficient funds which can be mitigated through tracking funds via MIS and levying health cess. Political bottlenecks to enforcing policies can be reduced by increasing public expenditure. Technical challenges around data privacy and maintenance costs require limiting access and strong security. Strengthening human resources can help remove quackery from the current healthcare system.
The document summarizes discussions from an international workshop on performance-based financing in the health sector in low-income countries. Several speakers presented on experiences with performance-based financing (PBF) in various countries. Agnes Soucat from the World Bank outlined challenges in achieving health targets and suggested that results-based financing could help overcome bottlenecks. Bruno Meessen argued for reforming public health systems using an institutional economics perspective. Agnes Soucat also presented on Rwanda's experience with PBF between 2002-2008, noting increases in health services and motivation. The workshop discussed evidence and lessons from PBF implementation in various contexts.
Achieving Maternal and Child Health with Results-Based Financing (RBF): The R...Kimberly Bumgarner
Presentation on the preliminary results coming in from the Health Results Innovation Trust Fund/World Bank pilot projects in Results-Based Financing (RBF) for Health
Scaling Up Performance Based Financing in Rwanda 2004-2008RikuE
This document summarizes Rwanda's scaling up of performance-based financing for its health system between 2004-2008. It began as pilot programs in three districts in 2002-2005 and was scaled nationwide by 2008. Key results of PBF included large increases in health services coverage like institutional deliveries and family planning, as well as improvements in health outcomes like decreased fertility and malaria rates. PBF involved paying health centers and workers based on the quantity and quality of services provided.
Olivier Basenya - PERFORMANCE BASED FINANCING in BURUNDIRikuE
This document outlines the implementation of performance-based financing (PBF) in Burundi's health sector. PBF was introduced to address issues like lack of health personnel and low quality of care. It was piloted in 2006-2007 across three provinces with support from NGOs. Initial results showed improved health indicators, quality of services, and motivation of health workers. The government now aims to scale up PBF nationwide by 2009 with support from partners like the World Bank and European Commission. Key future challenges include fully institutionalizing PBF and establishing independent funding agencies.
Evaluation of the Rwanda Community Performance-Based Financing ProgramRBFHealth
This study evaluates the impact of two interventions introduced as part of the Rwanda Community Performance-Based Financing Program to increase coverage of targeted maternal and child health services: rewards to cooperatives of community health workers and demand-side conditional in-kind transfers. The evaluation exploits experimental design with intervention randomly assigned at the sub-district level for a duration of two and a half years. The analysis finds no impact of the incentives to cooperatives of community health workers. However, conditional in-kind demand-side incentives are shown to significantly increase take up of timely antenatal and postnatal consultations.
The PRRINN-MNCH programme operated in four northern Nigerian states from 2006-2013 with the goal of improving maternal, newborn and child health services. It achieved significant impacts including:
1) Reducing maternal and child mortality and morbidity in the target states by strengthening health systems, service delivery, community engagement, and governance.
2) Providing evidence of value for money through improved health indicators and lives saved due to programme interventions.
3) Facing challenges in the unstable security environment, particularly in Yobe State, but continuing operations with government commitment to improving health services.
The Solomon Islands HiT determines that the country’s health system has significant weaknesses but also considerable strengths. Despite the range and difficulty of issues facing policy-makers in the Solomon Islands, there have been significant achievements in health, including considerable progress in advancing population health status. The performance of the health system is positive, achieving high coverage, high satisfaction levels, and steady progress on health outcomes. Nonetheless, the country faces important health challenges that could undermine development gains made to date
Olamide Okulaja_Creating synergy for PPP_PPP Conference2019Atinuke Akande
At the health policy dialogue organised by PharmAccess Foundation and Nigeria Health Watch on the 11th April 2019, Olamide Okulaja discussed Creating Synergy for public-private partnership in Nigeria.
Swot analysis of Safe motherhood, HIV & AIDS, ARI and Logistic Management Pro...Mohammad Aslam Shaiekh
The Acute Respiratory Tract Infection (ARI) program in Nepal aims to reduce childhood mortality from pneumonia through early diagnosis and treatment. The program trains female community health volunteers to diagnose pneumonia in children under 5 using an ARI timer and treat cases with antibiotics. It also educates mothers on the differences between cough/cold and pneumonia and the need for referral. While the program has increased access to care, analysis found low coverage of treatment at health facilities and by community health workers, suggesting the need for improved case management and coordination between levels of care.
The Kingdom of Tonga has had one of the best overall levels of health within the Pacific as a result of a dramatic reduction in communicable diseases and maternal and child mortality since the 1950s. It is also on target to achieve the Millennium Development Goals (MDG) around maternal and child mortality. Adapting its strong primary health-care system to deal with the large financial burden associated with chronic and noncommunicable diseases and ensuring quality primary health-care services in remote areas are the main health sector challenges facing Tonga.
The document provides a review of Tonga's health system. It summarizes that Tonga has a decentralized health system managed through 4 districts, with the majority of primary care and 90% of hospital services provided by the public sector. Key achievements include control of infectious diseases, high immunization coverage, and prioritization of non-communicable diseases. However, challenges remain such as high rates of non-communicable diseases and their risk factors. The health workforce faces issues of limited education opportunities and brain drain overseas. Infrastructure and medical equipment also require significant upgrades.
“Rachel Glennerster is Executive Director of the Abdul Latif Jameel Poverty Action Lab (J-PAL). HerRachel - Credit Blu Nordgren research includes randomized evaluations of community-driven development, the adoption of new agricultural technologies, and improving the accountability of politicians in Sierra Leone; empowerment of adolescent girls in Bangladesh; and health, governance, education, and microfinance programs in India. She serves as Scientific Director for J-PAL Africa, Co-Chair of J-PAL’s Agriculture Program and is a board member of the Agricultural Technology Adoption Initiative (ATAI). She is the lead academic for Sierra Leone for the International Growth Center. Between 2007 and 2010 she served on the UK Department for International Development’s (DFID) Independent Advisory Committee on Development Impact.
Rachel Glennerster helped establish Deworm the World, of which she is a board member, which has helped deworm 23 million children worldwide. Before joining J-PAL, she worked at the IMF and Her Majesty’s Treasury. She has a Ph.D. in economics from Birkbeck College, University of London. She is coauthor of Strong Medicine: Creating Incentives for Pharmaceutical Research on Neglected Diseases, and Running Randomized Evaluations.”
The document provides an overview of India's National Health Mission (NHM), which includes the National Rural Health Mission and National Urban Health Mission. The vision of NHM is universal access to equitable, affordable, and quality healthcare. Key goals include reducing maternal and infant mortality rates. The document outlines the governance structure of NHM at the national, state, and district levels. It also describes the major components and initiatives of NHM, including health systems strengthening, reproductive and child health programs, and national disease control programs. Implementation of NHM has increased healthcare infrastructure, utilization, and achieved several of its targets.
The document discusses progress on five future healthcare scenarios in Africa that were previously explored:
1) Preventive care has improved but rural-urban divides persist due to infrastructure and workforce challenges.
2) Business input and community empowerment models are developing through public-private partnerships and training of new healthcare worker tiers.
3) Several countries have advanced universal health coverage through insurance schemes but challenges remain in expanding coverage and improving quality.
4) Telemedicine has grown but infrastructure limitations remain, though mobile technologies are expanding access to care and insurance.
5) International donors seek greater impact through support for universal coverage and cash-strapped governments but roles remain crucial given funding shortfalls.
With this webinar, we invite you to join in the discussion on the post-Ebola strategy in West Africa. During the webinar four experts from different backgrounds will outline their view of the Ebola Crisis and most importantly share their vision on what needs to be done now, and post-Ebola, to ensure aversion of further food insecurity and social marginalization.
The spread of the Ebola virus disease has major consequences on the African countries it has hit the hardest: Guinea, Liberia, and Sierra Leone. The death toll from the disease and associated losses pose great economic consequences.
More than 2,600 people have died in West Africa. Transportation companies suspended their operations to the countries for fear of contamination even though the World Health Organisation advised against it. So far, the economies are experiencing adverse effects with escalating food insecurities.
Sierra Leone and Liberia, two of the most hit countries, recently came out of more than a decade of gruesome civil wars. Their institutions are still fragile and the deprivation from the Ebola crisis could trigger ever bigger problems.
The youth played a major role in both the Sierra Leone and Liberia conflicts as a result of economic and social marginalization. Without an effective strategy to assure young people a brighter future of economic and social stability, impact of the 2014 Ebola crisis on food insecurity and social livelihoods could trigger an even greater post-Ebola crises.
Agenda points:
Short term strategy: containment strategy & humanitarian aid
Long term strategy: improvement of (social) health care & international assistance
The importance of microprogrammes: Engagement, voicing the right people, AYM’s call for action**
The document discusses Rwanda's progress and goals for its health sector. It provides statistics showing that Rwanda has made significant improvements but still has progress to make to meet WHO recommended health standards. It outlines Rwanda's community-based health system and efforts to increase domestic funding sources and reduce out-of-pocket costs for citizens. Specific achievements highlighted include large declines in mortality rates from HIV/AIDS, malaria, tuberculosis and other diseases. Rwanda aims to continue expanding insurance coverage and improving quality of care across all levels of its health system.
The document discusses Rwanda's progress and goals for its health sector. It provides statistics showing that Rwanda has made significant improvements but still has progress to make to meet WHO recommended health standards. It outlines Rwanda's community-based health system and efforts to increase domestic funding sources and reduce out-of-pocket costs for citizens. Specific achievements highlighted include large declines in mortality rates from HIV/AIDS, malaria, tuberculosis and other diseases. Rwanda aims to continue expanding insurance coverage and improving quality of care across all levels of its health system.
Nigeria TSHIP: Bauchi State Summary Report 2015 JSI
The USAID-funded Targeted States High Impact Project (USAID|TSHIP) works to strengthen health care delivery in Bauchi and Sokoto states. The objective is to increase the use of high-impact integrated maternal, newborn, and child health (MNCH), and family planning and reproductive health (FP/RH) interventions. This summary looks at data from 2010 to 2015 and documents how the Government of Bauchi and USAID helped save the lives of 38,137 women and newborns.
Advancing Maternal, Newborn, and Child Health in Bauchi--TSHIP Final Dissemin...JSI
The Targeted Stats High Impact Project (TSHIP) is USAID/Nigeria's flagship health, population,and nutrition program. Implemented by JSI since 2009, TSHIP has provided technical assistance to Northern Nigeria's Bauchi and Sokoto States to promote high-impact health interventions, particularly for mothers and newborns.
This slideshow was presented at a final project dissemination meeting, held in Bauchi on July 7th, 2015.
Developing Ministry Capacity and Partnerships for Sustainability and Scale MO...CORE Group
This document summarizes a USAID-funded maternal and child survival project in rural Ghana and discusses partnerships for sustainability and scale. [1] It found high rates of maternal and child mortality at baseline due to poor uptake of health services and low government capacity. [2] The project partnered closely with Ghana Health Services at multiple levels to jointly implement activities, monitor outcomes, and strengthen local systems. [3] This led to significant improvements in maternal and child health indicators, as well as mechanisms to sustain and expand the work to additional districts in Ghana.
How can health accounts inform health sector investments? Lessons from countr...HFG Project
Countries must have a firm grasp on their health financing landscape in order to ensure sufficient and effective use of resources. Health Accounts—an internationally standardized methodology that allows a country to understand the source, magnitude, and flow of funds through its health sector—provide a wealth of information on past spending. When combined with macroeconomic, health utilization, and health indicator data, Health Accounts provide powerful insights for health financing policy.
USAID’s Health Finance and Governance (HFG) project supports countries to institutionalize their Health Accounts so that they are produced regularly and efficiently, and are a useful tool for policymakers. In this technical briefing webinar, held June 29, 2016, HFG experts used country examples to demonstrate how Health Accounts have been (and can be) used to inform national health financing decisions. The experts also provided perspectives on the future of Health Accounts.
Key elements of NHM, Important learnings, Challenges Desired InterventionsDr. Heera Lal IAS
This document provides an overview of the key elements, achievements, and challenges of the National Health Mission (NHM) in India. It discusses how NHM has strengthened India's public health system and led to important health improvements, but that challenges remain. Key interventions and priorities for the road ahead are also outlined.
"Looking Ahead" Post-Ebola Strategy in West Africa is the first in a series of planned webinars, where we invite knowledgeable individuals and participants to join the post-Ebola strategy in West Africa discussion.
During the webinars, experts from different backgrounds, will outline their view on the Ebola Crisis and most importantly, share their vision on what needs to be done now, and post-Ebola, to ensure aversion of further political and economic disturbances.
The fast spread of the Ebola virus has major consequences on the African countries it has hit the hardest: Guinea, Liberia, and Sierra Leone.
Besides the death tolls and associate losses, the countries are also facing great danger because of the economic consequences the virus carries.
Sierra Leone and Liberia, two of the most hit countries, have both recently come out of more than a decade of gruesome civil wars and the set back of the disease does not help with the stabilization of the economies. Their democracies are fragile and the deprivation from the Ebola crisis could be a trigger for political disruption.
The youth played a major role in those conflicts as a result of economic and social marginalization. Without a post-Ebola strategy to ensure the youth a future of economic and social stability, there may be unforeseeable instabilities.
ABOUT THE ORGANIZER:
Twenty-First Century African Youth Movement, (AYM) empowers and mobilizes Africa’s youth through employment. The AYM is dedicated to developing new and exciting enterprise opportunities for young people in Sierra Leone, to help provide young people with the confidence, power and skills they need to get themselves into employment and out of poverty.
Mobilizing Africa’s unemployed and underemployed youth is the key to the continent’s economic growth and stability. AYM works to mobilize marginalized youth through education, training, and employment, creating entrepreneurial opportunities to help move communities away from poverty, disease, and hunger. AYM aims to establish personal empowerment and community resilience by energizing the continent’s youth population, its most critical resource in the reversal of social and economic stagnation.
For more information, visit:
http://www.aym-inc.org/ebola-looking-ahead/.
AYM’s call for action:
Dr David J Baumler’s AYM Pepper Challenge: http://youtu.be/iU1Ot60mT7I
Similar to Providing Health in Difficult Contexts: Pre-Pilot Performance-Based Financing Experiences in Adamawa State in North-East Nigeria (20)
Cost-Effectiveness Analysis of RBF in Zimbabwe and ZambiaRBFHealth
Profs. Shepard and Zeng have been leading projects for the Bank to develop methods for performing a cost-effectiveness analysis of Results-Based Financing (RBF) programs and applying them to maternal-child health (MCH) services in Zambia and Zimbabwe. Both countries’ RBF programs proved highly cost-effective. Methods and results should be informative to other RBF and MCH programs.
RBF districts saw increases in some key health indicators compared to control districts, including institutional deliveries and the timing of first antenatal care visits. Quality of services improved in some areas for RBF districts such as structural quality indices and availability of some delivery equipment. Health systems were strengthened under RBF, with increases in facility governance, autonomy, and job satisfaction reported compared to control districts. The results provide evidence that RBF had a positive impact on priority health services in Zambia.
Performance-based financing of maternal and child health: non-experimental ev...RBFHealth
Ellen Van de Poel presents the findings of two studies that evaluate the impact of Performance-Based Financing (PBF) in Burundi and Cambodia. Both studies exploit the geographic expansion of PBF to estimate its effect on the utilization of maternal and child health services using data from the Demographic Health Surveys.
Success beyond numbers: The Salud Mesoamerica Initiative’s results-based fin...RBFHealth
The Salud Mesoamérica Initiative (SMI) is a public-private partnership between the Bill & Melinda Gates Foundation (BMGF), the Carlos Slim Foundation, the Government of Spain, the Inter-American Development Bank (IDB), the countries of Central America and the State of Chiapas in Mexico. SMI works to reduce maternal and health inequalities through a results-based financing model, aligned with priorities established by the governments of the region. Among the poor in Mesoamerica, only 5 out of every 10 pregnant women are attended during childbirth by skilled birth personnel and the mortality rate among children in poverty is twice that of the national average.
Building agile and data-driven health system is a fundamental component of the Universal Health Coverage agenda. Data-driven health systems will require that countries set up smart data systems coupled with dynamic and reactive health financing instruments.
A large number of the low-income countries enhance their strategic purchasing function with the introduction of Results-Based Financing (RBF) instruments. In this presentation, Nicolas de Borman describes how the combination of DHIS2 platforms, RBF and mobile devices help build strategic purchasing function in health systems.
Sumar Program's Universal Coverage: Achievements & New Goals Towards 2020RBFHealth
A presentation by Martín Sabignoso of Argentina's Ministry of Health delivered at the RBF Health Seminar, QOn the Road to Effective Universal Health Coverage: What’s New in Argentina’s Use of Performance Incentives? on June 11, 2015.
Long run effects of temporary incentives on medical care productivity in Arge...RBFHealth
A presentation by Pablo Celhay, Paul Gertler, Paula Giovagnoli and Christel Vermeersch, delivered at the RBF Health Seminar, On the Road to Effective Universal Health Coverage: What’s New in Argentina’s Use of Performance Incentives? on June 11, 2015.
Qualitative Research in Results-Based Financing: The Promise and The RealityRBFHealth
This document summarizes a review of qualitative research conducted as part of results-based financing (RBF) studies. The review assessed 17 RBF studies and found that while qualitative research holds promise to understand complex health systems, several challenges exist in practice. Studies often lacked depth in contextualization, sampling, and data collection methods. Opportunities exist to strengthen qualitative RBF research through more formative work to inform study design, locally grounded conceptual frameworks, strengthened fieldwork practices, and smaller, more focused qualitative components.
Effect of Voucher Programs on Utilization, Out-of-Pocket Expenditure and Qual...RBFHealth
A presentation by Timothy Abuya, delivered at the RBF Health Seminar, The Role of Vouchers in Serving Disadvantaged Populations and Improving Quality of Care.
A presentation by Ben Bellows, delivered at the RBF Health Seminar, The Role of Vouchers in Serving Disadvantaged Populations and Improving Quality of Care.
WHO Implementation Research Program on Factors Explaining Success and Failure...RBFHealth
This document discusses implementation research on scaling up Results-Based Financing (RBF) programs from pilot schemes to integrated national health systems. It calls for case studies on RBF initiatives in select low and middle-income countries to identify factors that enable or hinder this transition. Selected proposals will examine RBF scale-up experiences in multiple countries. Next steps include a protocol development workshop to design the research and analyze findings to draw cross-cutting lessons on scaling up RBF.
The Science of Delivery: Use of Administrative Data in The HRITF PortfolioRBFHealth
A presentation by Ha Thi Hong Nguyen, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014. This event was hosted by the Health Results Innovation Trust Fund at The World Bank, in partnership with the PBF Community of Practice in Africa.
PBF Conceptual Framework and Illustration with The Case of NigeriaRBFHealth
A presentation by Dinesh Nair, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014. This event was hosted by the Health Results Innovation Trust Fund at The World Bank, in partnership with the PBF Community of Practice in Africa.
Zimbabwe: Results-Based Financing Improves Coverage, Quality and Financial Pr...RBFHealth
A presentation by Dr. Gwinji, Permanent Secretary, Ministry of Health, Zimbabwe and Dr. Tafadzwa Goverwa- Sibanda, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014. This event was hosted by the Health Results Innovation Trust Fund at The World Bank, in partnership with the PBF Community of Practice in Africa.
India - Karnataka: An Experimental Evaluation of Government Health Insurance ...RBFHealth
A presentation by Somil Nagpal, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014. This event was hosted by the Health Results Innovation Trust Fund at The World Bank, in partnership with the PBF Community of Practice in Africa.
What Are Results-Based Financing Programs Doing Around The World, State of Th...RBFHealth
A presentation by Dinesh Nair, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014. This event was hosted by the Health Results Innovation Trust Fund at The World Bank, in partnership with the PBF Community of Practice in Africa.
A presentation by Bruno Meessen, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014.
Innovations in Results-Based Financing in the Latin America and Caribbean RegionRBFHealth
Presentations delivered during "Innovations in Results-Based Financing in the Latin America and Caribbean Region" seminar at the World Bank on May 22, 2014.
These slides feature a comparative review of different types of results-based financing schemes in the Latin America and Caribbean region, as well as case studies from selected schemes.
Understanding Behavioral changes in Mental Distress.pdfAdetayo Kaife
Sometime ago, I had the privilege of hosting a LinkedIn webinar focused on understanding behavioral changes in individuals experiencing mental distress. I broke down this complex topic into easily understandable segments, and the positive feedback was overwhelming. Many attendees found the information incredibly valuable and requested access to the presentation slides.
I’m pleased to announce that I’ve now made these slides available for free on SlideShare. Whether you're in the medical field or not, these resources can help you better understand and support someone going through a mental health crisis.
You don’t need to be a healthcare professional to make a difference.
World Health Organization Guidelines on Nutrition .pptxMopideviSravani
WHO is the directing and coordinating authority for health. It is responsible for providing
leadership on global health matters, shaping the health research agenda, setting norms and
standards, articulating evidence-based policy options, providing technical support to countries
and monitoring and assessing health trends.
WHO guidelines on Nutrition:
1. Guideline: iron and folic acid supplementation in menstruating women
2. Guideline: iron supplementation in preschool and school-age children
3. Guideline: Neonatal vitamin A supplementation
4. Guideline: Vitamin A supplementation during pregnancy for reducing the risk of mother-tochild transmission of HIV
5. Guideline: Vitamin A supplementation for infants 1-5 months of age
6. Guideline: Vitamin A supplementation in postpartum women
The Future of Hair Loss Treatment: Harnessing Stem Cells with Dr. David GreeneDr. David Greene Arizona
Hair loss is no longer a condition that must be endured in silence. Thanks to the groundbreaking work of experts like Dr. David Greene, stem cell therapy is emerging as a powerful tool in the fight against hair loss. With continued research and development, this innovative approach holds the promise of transforming the lives of those affected by hair loss, offering a future where a full head of hair can be restored naturally and effectively.
In the healthcare field, precise and comprehensive documentation is essential for delivering high-quality patient care. One of the most critical components of clinical documentation is the SOAP note. At GPAShark.com, we specialize in providing expert SOAP note writing services, tailored to meet the needs of nursing students, healthcare professionals, and medical practitioners. Our goal is to help you master the art of SOAP note writing, ensuring your documentation is thorough, accurate, and effective.
Understanding SOAP Notes
SOAP stands for Subjective, Objective, Assessment, and Plan. This structured method of documentation is used widely in healthcare settings to ensure consistent and clear communication among healthcare providers. Each component of a SOAP note serves a specific purpose:
Subjective (S):
This section captures the patient's narrative, including their chief complaint, history of present illness (HPI), past medical history (PMH), family history (FH), social history (SH), and review of systems (ROS). It reflects the patient's perspective and is crucial for understanding their condition and concerns.
Objective (O):
The objective section includes measurable and observable data collected during the physical examination and diagnostic tests. This might involve vital signs, laboratory results, imaging studies, and physical exam findings. Objectivity is key to providing a factual basis for the assessment.
Assessment (A):
In the assessment section, the healthcare provider synthesizes the subjective and objective data to formulate a diagnosis or differential diagnoses. This analysis helps in understanding the patient's condition and guiding the treatment plan.
Plan (P):
The plan outlines the course of action, including treatment strategies, medications, diagnostic tests, patient education, and follow-up appointments. It provides a roadmap for managing the patient's condition and achieving desired health outcomes.
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Providing Health in Difficult Contexts: Pre-Pilot Performance-Based Financing Experiences in Adamawa State in North-East Nigeria
1. The Adamawa Primary Health Care System
Dr Abdullahi Dauda Belel
Chairman, Adamawa SPHCDA, Nigeria
Shun Mabuchi, Health Specialist, WB
24th April 2014
1
3. In Nigeria, Health centers suffer from underlying systemic issues
What you will see at a primary health care center:
• Relatively abundant workers (among top in SSA)
• Chronic stock-outs of essential drugs (Avg. 55%)
• Lack of minimum equipment (Avg. 25%
equipped)
• Poor sanitation/waste management
• Idle health workers/absenteeism (Avg. 29%)
• Correct mgmt. of maternal complication (17.3%)
• No patients (Avg. 1.5 patients per day)
Underlying systemic issues:
• Fragmentation and poor coordination between
federal, state and local govt levels
• Unclear accountability and poor performance
review to strengthen it
• No incentives to good or poor performance
• No cash and autonomy at health facilities
Source: Service Delivery Indicator (SDI) Survey, 2013
4. Nigeria has been a largest contributor
of maternal and child mortality
Description
• 33,000 women
each year
• An estimated
70% of these
deaths are
preventable
• ~ 1 million
deaths each
year
SOURCE: FMOH Presentation (NDHS 2008), Rajaratnam et al. 2010, UN Report 2012
Maternal
mortality
rate (100k
live births)
Infant
mortality
rate (1000
live births)
Under 5
mortality
rate (1000
live births)
14%
8%
9%
Nigeria’s global share
157
104
75
65
545
500
Nigeria
vs. SSA
Nigeria
Sub-Saharan
Africa
4
5. NSHIP aims to address the systemic issues by financing for
results and monitoring rigorously
Project Approach in Nigeria
(US$ 170 M, 5 years, 3 States)
• Health service coverage
• Budget execution
• Bonus payment
• Quantity of services delivered
• Quality scores of the services
• Supervision
• HMIS reporting
• HR management
Finance based on.. (Examples)
5
$$
$$
$$
State
Govt.
Local
Govt.
Health
Centers
Federal
Govt.
Disburse-
ment linked
indicator
(DLI)
PBF
Main
Driver
6. NSHIP is being scaled up after 2 years of pre-
pilot implementation
’11 2012 2013 2014
De
c
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
Pre-pilot
started
PBF Pre-
pilot (36
facilities)
PBF Scale-
up
DLI
6 months
payment delays
Subcontracting
started for 4 services
Demand-side
interventions
pre-pilot
Project
effectiveness
(Aug 2013)
+3 PBF
LGAs
+3 PBF LGAs
TA Agency
Almost all 2011-12
DLIs achieved
(May 2013)
FY 2013 DLI
review planned
in May
Scope of data
analysis
6
7. Adamawa Background Information
Adamawa State is located in Northeast of Nigeria
Projected 2014 Population of 3,87m
Has 21 LGAs and 226 Wards
Among the 5 poorest States in Nigeria
A major contributor to the Nigeria’s poor health indicators
Health sector has very minimum private sector
participation while the public facilities are in a deplorable
State
7
9. Background Information
The entire sector is currently under reform, using PBF as a
strategy
The State is piloting PBF for GON but adopted it as strategy
for strengthening the health system
Focused primarily on strengthening the Ward Health System
(WHS) and Primary Health Care Under One Roof (PHCOUR)
Ensuring that funds are made available at the service points,
guided by deliberate and focused plans
MNCH is placed at the frontline in PBF design and its scale
up is supported by EU-UNICEF
9
10. Background Information
Implementation arrangements is aligned to the
attainment of the NSHDP’s objectives
Pre-Pilot evaluation revealed encouraging results and
further clarified areas for immediate and long term
adjustments for the scale up
10
11. Demsa
Fuf ore
Gany e
Girei
Gombi
Guy uk
Hong
Jada
Lamurde
Madagali
Maiha
May obelwa
Michika
Mubi North
Mubi South
Numan
Shelleng
Song
Toungo
Yola North
Yola South
PBF Introduction
11
PBF
PBF scale up
DFF
12. Progress in Implementation
Key Officers: SMOH, ADPHCDA trained on PBF In
Mombasa-Kenya and Enugu-Nigeria
Pre-Pilot (Fufore LGA) was chosen
Rural LGA – Pop ~ 240,160
Political Wards: 11
A Cottage Hospital (Secondary HF)
Baseline assessment of HFs and Communities done
12
13. Progress in Implementation
15 HFs selected: 14 HCs for MPA & 1 GH for CPA
Management structures at LG level constituted and
inaugurated (2012)
LG RBF Steering Committee
WDCs
HF RBF Committees (both HCs & Hospital)
IMC (both HCs & Hospital)
Bank Accounts for both HCs & Hospital opened
13
20. Success story
Mayo-Ine health centre went from 4 deliveries per month
to 45 deliveries per month within a six-month period
It has sustained that rate over the rest of the year, and this
means that, for its entire sub-district population, it had
gone from delivering10% of pregnant women to
delivering 100% of all expected deliveries in its health
facility.
Mayo-Ine health center has effectively reached universal
coverage for institutional deliveries.
21. Success story
So what happened in Mayo-Ine?
As you can imagine, there must have been a tremendous change
from what was there before.
The changes led to its staff working harder, going out to villages
and talking to the population.
The staff involved the local community and traditional leaders in
convincing the population to use its services.
The health facility received autonomy and a bank account and
learned to manage money.
Working hours were changed from Monday to Friday 8 am to 4 pm
to 24/7. One additional staff, a lab assistant, was hired.
22. Success story
The staff purchased drugs and medical materials from certified distributors; it
purchased new equipment, repaired the broken fence, the windows, repaired the
toilets, and fixed the waste disposal.
The changes led to health workers linking to their health posts and using these
also to provide services, to provide growth monitoring, and vaccinations
Patients who would come would be prescribed essential drugs according to
protocols which made it more affordable for them
The district health team came frequently for supervision, and provided targeted
feed-back using a checklist.
Technical assistance from the State Primary Health Care Development Agency
ensured that health staff was coached in using money, in managing their staff and
in using new strategies to improve their health services.
24. Success story
And most difficult of all: health workers convinced all
pregnant women, all of them, to come and deliver in their
health facility.
The health staff changed their attitudes to patients, ensured
that the equipment was there, that the environment in which
they had to deliver was nice, that it had water, sanitation, a
bed with clean sheets and a pleasant atmosphere.
Women who delivered did not have to pay any more for
drugs or needles or to bring maternity pads.
In fact, women who delivered were given small items such
as maternity pads, and clothes for their babies.
25. Success story
The health workers did the hardest thing of all: to regain
the trust of the population by convincing them to use the
public health services again and to use it for all their
health needs.
Today, Mayo-Ine health center is a beacon for Fufore
LGA, for Adamawa State, and also for Nigeria.
If Mayo-Ine can do it, in this far outpost of Nigeria, then
anybody can do it.
33. In contrast, a few indicators suggest challenges to address
through broader approaches/partnerships
Adamawa
Nasarawa
Ondo
PMTCT: HIV+ mothers and children born to
are treated according protocol (%)
0%
10%
20%
30%
40%
50%
60%
12 2 4 6 8 10 12 2 4 6 8 10 12
- Other factors (PMTCT
center, supply, etc.)
may influence
- Critical review of
reasons and potential
partnership (e.g., GF)
VCT/PMTCT/PIT test (Standardized to Avg.
population of 3 LGAs)
0
200
400
600
800
1000
1200
1400
1600
1800
12 2 4 6 8 10 12 2 4 6 8 10 12
Good
achievement
(3-5 per day)
3
34. Deeper look at data suggests large variations in
performance among health centers
Number of Institutional Delivery in Fufore (Adamawa),
standardized by average catchment population
• Before PBF, all
PHCs were
equally at
very low levels
• With PBF,
some
achieved
100%
coverage
while others
are struggling
without major
improvements
-
20
40
60
80
100
120
140 Pariya HC
Chigari HC
Dasin Hausa HC
Farang HC
Ribadu HC
Furore MCH HC
Choli HC
Gurin HC
Malabu HC
Karlahi HC
Wuro Bokki HC
PBF
started
34
35. A qualitative case study suggested the
importance of community engagement and
health center management
Determinants Non-Determinants
• Community engagement
(e.g., involve community
leaders, daily visits, individual
follow-ups and incentives for
use of facility)
• Mangers’ management
capacity (e.g., full staff
involvement, improve staff
environment, rigorous
performance review)
Identified determinants and non-determinants of performance
(preliminary)
• Level of staffing (best
performers lack staff)
• Remoteness of facilities (best
performers are very rural)
• Technical qualifications of OIC
(community worker manage
well)
• Business planning (none use it
effectively yet)
35
Source: Preliminary report of qualitative case study on key determinants of performance
Focused management strengthening of the PHCs has potential to
improve performance significantly – Adamawa partners with UNICEF/EU
to address it
36. Adamawa Nasarawa Ondo
From (2011) To (2013)
Significant improvement has been observed in many areas,
with a few areas of consistently low scores
37. Detailed indicator review for Adamawa revealed issues
beyond Facilities in the areas with consistently low scores
37
Staffing issues
Infrastructure issues
Issues that needs
federal/state
leadership
• FP Staff
• Lab technician
• Fence
• EPI fridge
• ARI protocol, malaria treatment, treatment
with antibiotics < 30%, IMCI, nutritional status
• Indigent committee
• Prescription form for essential drugs
Staffing and infrastructure
issues influence other
scores in the same section
(e.g., the entire section
can be zero without staff
or EPI fridge)
ExamplesUncontrollable Areas
Maximum scores without state/LGA/partner
support on above areas will be 80-85%
38. NSHIP pre-pilot has been achieving significant improvements with
very low marginal additional investment
$0.00
$0.50
$1.00
$1.50
$2.00
$2.50
$3.00
$3.50
Year 1 Year 2 Year 3 Year 4
Paymentpercapita
“Year” means complete 12 calendar months counting from the month when program
started
Value for the most recent year is extrapolated if duration is less than 12 months
Payment components consist of:
• Quantity only in Zambia
• Quantity, quality, and equity bonus in Burkina Faso and Zimbabwe
• Quantity and quality in all other countries
Payment per capita – multi-country comparison
Health Expenditure per
capita in Nigeria:
US$161.4 (2012)
38
39. Key challenges and next steps
Challenges/Findings Possible next steps
• Scaling-up PBF requires large
amount of capacity at state
and federal levels
• Procurement of technical assistance
• Innovative approaches to increase
state capacity (e.g., internship)
Scale up
capacity
Payment
delays
• Payment delays deteriorate
performance significantly
• Simplify the approval process
• Develop payment tracking system
• Hold stakeholders accountable with
performance framework/DLIs
Broader
reforms
• As PBF improves services,
issues such as demand-side
barriers, health center
staffing, vaccine supply,
health center management
emerge as bottlenecks
• Combine targeted intervention
(e.g., transport voucher)
• Strengthen the engagement with
the federal/state government
• Link with others in broader reforms
and capacity building
39
40. Lessons Learned
• Providing autonomy, operational cash and result-focus can
improve the performance of health centers significantly
• Policy and technical champions can make PBF as efficient
service delivery platform
• Success of PBF hinges on how well and quickly we can learn
from implementation and improve approaches
• Robust operational data and targeted qualitative researches
provide tremendous opportunities for us to identify and
problem-solve implementation issues
• Strengthened learning functions will challenge us on our
capacity to adapt approaches in dynamic ways
• Having a pilot period allows intensive learning and
improvement
40
41. What’s Responsible?
Many factors but mainly
Political will supporting change by the State Governor
Having clear institutional arrangement with separation of
functions
Having PHC Under One Roof and empowering the PHC
Agency with autonomy
Strong mentoring (and WB TA support) and follow-up
programme by the SPHCDA using the PBF Manual
Autonomy given to the facilities to improve their staff
strength, engage communities and utilize cash to solve
immediate needs
41