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Estimates of aid for reproductive, maternal, newborn, and child health: findings from application of the Muskoka2 method, 2002–17

Dingle, A.; Schäferhoff, M.; Borghi, J. et al. The Lancet (2020) CC

Background Four methods have previously been used to track aid for reproductive, maternal, newborn, and child health (RMNCH). At a meeting of donors and stakeholders in May, 2018, a single, agreed method was requested to produce accurate, predictable, transparent, and up-to-date estimates that coul...d be used for analyses from both donor and recipient perspectives. Muskoka2 was developed to meet these needs. We describe Muskoka2 and present estimates of levels and trends in aid for RMNCH in 2002–17, with a focus on the latest estimates for 2017. Methods Muskoka2 is an automated algorithm that generates disaggregated estimates of aid for reproductive health, maternal and newborn health, and child health at the global, donor, and recipient-country levels. We applied Muskoka2 to the Organisation for Economic Co-operation and Development's Creditor Reporting System (CRS) aid activities database to generate estimates of RMNCH disbursements in 2002–17. The percentage of disbursements that benefit RMNCH was determined using CRS purpose codes for all donors except Gavi, the Vaccine Alliance; the UN Population Fund; and UNICEF; for which fixed percentages of aid were considered to benefit RMNCH. We analysed funding by donor for the 20 largest donors, by recipient-country income group, and by recipient for the 16 countries with the greatest RMNCH need, defined as the countries with the worst levels in 2015 on each of seven health indicators. Findings After 3 years of stagnation, reported aid for RMNCH reached $15·9 billion in 2017, the highest amount ever reported. Among donors reporting in both 2016 and 2017, aid increased by 10% ($1·4 billion) to $15·4 billion between 2016 and 2017. Child health received almost half of RMNCH disbursements in 2017 (46%, $7·4 billion), followed by reproductive health (34%, $5·4 billion), and maternal and newborn health (19%, $3·1 billion). The USA ($5·8 billion) and the UK ($1·6 billion) were the largest bilateral donors, disbursing 46% of all RMNCH funding in 2017 (including shares of their core contributions to multilaterals). The Global Fund and Gavi were the largest multilateral donors, disbursing $1·7 billion and $1·5 billion, respectively, for RMNCH from their core budgets. The proportion of aid for RMNCH received by low-income countries increased from 31% in 2002 to 52% in 2017. Nigeria received 7% ($1·1 billion) of all aid for RMNCH in 2017, followed by Ethiopia (6%, $876 million), Kenya (5%, $754 million), and Tanzania (5%, $751 million). Interpretation Muskoka2 retains the speed, transparency, and donor buy-in of the G8's previous Muskoka approach and incorporates eight innovations to improve precision. Although aid for RMNCH increased in 2017, low-income and middle-income countries still experience substantial funding gaps and threats to future funding. Maternal and newborn health receives considerably less funding than reproductive health or child health, which is a persistent issue requiring urgent attention. Funding Bill & Melinda Gates Foundation; Partnership for Maternal, Newborn & Child Health. more

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National spending on health by source for 184 countries between 2013 and 2040

Dieleman, J.; Templin, T.; Sadat, N. et al. (2016) CC

A general consensus exists that as a country develops economically, health spending per capita rises and the share of that spending that is prepaid through government or private mechanisms also rises. However, the speed and magnitude of these changes vary substantially across countries, even at simi...lar levels of development. In this study, we use past trends and relationships to estimate future health spending, disaggregated by the source of those funds, to identify the financing trajectories that are likely to occur if current policies and trajectories evolve as expected. Methods We extracted data from WHO's Health Spending Observatory and the Institute for Health Metrics and Evaluation's Financing Global Health 2015 report. We converted these data to a common purchasing power-adjusted and inflation-adjusted currency. We used a series of ensemble models and observed empirical norms to estimate future government out-of-pocket private prepaid health spending and development assistance for health. We aggregated each country's estimates to generate total health spending from 2013 to 2040 for 184 countries. We compared these estimates with each other and internationally recognised benchmarks. Findings Global spending on health is expected to increase from US$7·83 trillion in 2013 to $18·28 (uncertainty interval 14·42–22·24) trillion in 2040 (in 2010 purchasing power parity-adjusted dollars). We expect per-capita health spending to increase annually by 2·7% (1·9–3·4) in high-income countries, 3·4% (2·4–4·2) in upper-middle-income countries, 3·0% (2·3–3·6) in lower-middle-income countries, and 2·4% (1·6–3·1) in low-income countries. Given the gaps in current health spending, these rates provide no evidence of increasing parity in health spending. In 1995 and 2015, low-income countries spent $0·03 for every dollar spent in high-income countries, even after adjusting for purchasing power, and the same is projected for 2040. Most importantly, health spending in many low-income countries is expected to remain low. Estimates suggest that, by 2040, only one (3%) of 34 low-income countries and 36 (37%) of 98 middle-income countries will reach the Chatham House goal of 5% of gross domestic product consisting of government health spending. Interpretation Despite remarkable health gains, past health financing trends and relationships suggest that many low-income and lower-middle-income countries will not meet internationally set health spending targets and that spending gaps between low-income and high-income countries are unlikely to narrow unless substantive policy interventions occur. Although gains in health system efficiency can be used to make progress, current trends suggest that meaningful increases in health system resources will require concerted action. Funding Bill & Melinda Gates Foundation. more

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Plan Stratégique du Secteur de la Santé pour la Réforme

Ministère de la Santé Publique et de la Population, Haiti (2008) CC

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Improving the quality of health services: tools and resources

World Health Organization WHO (2019) C_WHO

This compendium collates current tools and resources on quality improvement developed by the WHO Service Delivery and Safety Department and provides examples of how the tools and resources have been applied in country settings. The target audience for this document are ministries of health, facility... more

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Health systems resilience in managing the COVID-19 pandemic: lessons from 28 countries

Haldane, V., De Foo, C., Abdalla, S.M. et al. (2021) C1

Nat Med (2021). https://doi.org/10.1038/s41591-021-01381-y

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РУКОВОДСТВО ПО НАЦИОНАЛЬНОЙ ПОЛИТИКЕ И СТРАТЕГИИ В ОБЛАСТИ КАЧЕСТВА

World Health Organization WHO (2018) C1

Практический подход к разработке политики и стратегии в целях повышения качества медицинской помощи

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Health systems resilience toolkit: a WHO global public health good to support building and strengthening of sustainable health systems resilience in countries with various contexts

World Health Organization WHO (2022) C_WHO

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Guide to Operational Research in Programs Supported by The GLOBAL FUND

World Health Organization; The Global Fund (2009)

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Philippines: National Objectives for Health 2011 - 2016

Department of Health (DOH) (2012) C1

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Implementation Research in Health – A Practical Guide

David H. Peters, Nhan T. Tran, Taghreed Adam Alliance for Health Policy and Systems Research (AHPSR) and World Health Organization (2013)

This guide is an attempt to redress the deficit in understanding of implementation research and to encourage programme personnel and implementers to take a greater interest in the subject, recognizing that implementation research is in fact an integral part of programme planning and execution, rathe... more

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Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995–2050

Global Burden of Disease Health Financing Collaborator Network The Lancet (2019) CC

Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and ... more

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The H6 Partnership vision

Joint United Nations Programme on HIVAIDS (UNAIDS) (2018) C1

A catalyst for transformation in the United Nations to deliver health results for women, children and adolescents in support of the Sustainable Development Goals

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Monitoring and Evaluation Toolkit: HIV, TB and Malaria and Health Systems Strenghtening

The Global Fund (2011)

The TB section of the toolkit presents selected (a) programmatic output and (b) outcome and impact indicators for TB. In addition to recommended monitoring programs and measuring the outcomes and impact of TB programs, indicators for the strengthening of health systems, strengthening of community sy... more

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The Essential Public Health Functions in the Americas: A Renewal for the 21st Century. Conceptual Framework and Description

Pan American Health Organisation PAHO (2021) C_WHO

The document is structured into five sections. The first presents the key experiences and challenges that justify a renewal of the EPHFs. The second section updates the groundwork for the exercise of public health and provides a framework to inform the exercise of the new essential functions. The th... more

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Quality of care in fragile, conflict-affected and vulnerable settings: taking action

World Health Organization WHO (2020) CC

In fragile, conflict-affected and vulnerable settings, delivery of quality health services faces significant challenges, including disruption of a routine health service organization and delivery systems, increased health needs, complex and unpredictable resourcing issues, and vulnerability to multi... more

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Malawi Service Provision Assessment (SPA) 2013-14. Key Findings

Ministry of Health (MoH), Malawi and ICF International (2014) C1

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Las normas Esfera y la respuesta al coronavirus

Sphere - Standards (2020) C2

El coronavirus se está extendiendo a nivel mundial. ¿Cómo pueden los individuos, las comunidades y los actores humanitarios responder mejor al brote de COVID-19? ¿Cómo puede el Manual Esfera orientar nuestra respuesta? Este documento tiene dos secciones: A. La primera sección aborda los... more

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Política Nacional de Investigación para la Salud

Ministerio de Salud Pública y Bienestar Social Paraguay, et al. (2010) C1

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Gli standard Sphere e la risposta al Coronavirus

Sphere - Standards (2020) C2

Il Coronavirus1 si sta diffondendo a livello globale. In che modo possono persone, comunità ed agenzie umanitarie fornire un’assistenza efficace durante l’epidemia di COVID-19? In che modo può il manuale Sphere guidare il nostro intervento? Questo documento si compone di due sezioni: A. La... more

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Supporting improvement of infection prevention and control programmes at national and facility levels in Ukraine during the COVID-19 pandemic in 2020: report

World Health Organization WHO, Regional Office of Europe (2021) CC

This report offers a summary of the provided support and recommendations on priority activities for IPC improvement at national and facility levels. The COVID-19 pandemic spotlighted areas for improvement in the IPC programme at national and facility levels. Improvements in the IPC programme were ac... more