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DHS Methodological Report No. 20
This study used Service Provision Assessment (SPA) and Demographic and Health Survey (DHS) data from Haiti, Malawi, and Tanzania to compare traditionally used additive methods with a data reduction method—principal component analysis (PCA).
We scored ... the quality of health facilities with three approaches (simple additive, weighted additive, and PCA) for two constructs: quality of services, with only facilities-level data, and quality of care, which incorporates observation and client data. We ranked facilities as high, medium, or low quality based on their scores. Our results indicated that the rankings change with the scoring methodology. There was more consistency in the rankings of facilities by the simple additive and PCA methods than the weighted additive and PCA-based rankings. This may be due to the low factor loadings and little variance explained by the first component in the PCA. We aggregated facility scores to their respective DHS clusters (Haiti, Malawi) or regions (Tanzania) and geographically linked them to women interviewed in DHS surveys to test associations between the use of family planning services and the quality environment, as measured with each index. more
This study used Service Provision Assessment (SPA) and Demographic and Health Survey (DHS) data from Haiti, Malawi, and Tanzania to compare traditionally used additive methods with a data reduction method—principal component analysis (PCA).
We scored ... the quality of health facilities with three approaches (simple additive, weighted additive, and PCA) for two constructs: quality of services, with only facilities-level data, and quality of care, which incorporates observation and client data. We ranked facilities as high, medium, or low quality based on their scores. Our results indicated that the rankings change with the scoring methodology. There was more consistency in the rankings of facilities by the simple additive and PCA methods than the weighted additive and PCA-based rankings. This may be due to the low factor loadings and little variance explained by the first component in the PCA. We aggregated facility scores to their respective DHS clusters (Haiti, Malawi) or regions (Tanzania) and geographically linked them to women interviewed in DHS surveys to test associations between the use of family planning services and the quality environment, as measured with each index. more
A Focus on the Journey to Self-Reliance for Preventing Child and Maternal Deaths . June 2018
The 2018 Acting on the Call report focuses on 25 countries’ journeys to self-reliance for preventing child and maternal deaths. Self-reliance is a country’s ability to finance and implement solution ... s to its own development challenges. Understanding where countries lie on this effort - known as the journey to self-reliance - helps USAID to best partner with countries and support their efforts.
The report looks at the health status of 25 priority countries as well as the current capacity of the health system to meet the needs of women and children. In the report, we recount progress since the 2012 Call to Action as well as identify gaps in order to inform future programming and areas that need strengthening during the journey to self-reliance. For the first time ever, we’ve calculated the return on our investment to eliminate bottlenecks to improving health services. more
The 2018 Acting on the Call report focuses on 25 countries’ journeys to self-reliance for preventing child and maternal deaths. Self-reliance is a country’s ability to finance and implement solution ... s to its own development challenges. Understanding where countries lie on this effort - known as the journey to self-reliance - helps USAID to best partner with countries and support their efforts.
The report looks at the health status of 25 priority countries as well as the current capacity of the health system to meet the needs of women and children. In the report, we recount progress since the 2012 Call to Action as well as identify gaps in order to inform future programming and areas that need strengthening during the journey to self-reliance. For the first time ever, we’ve calculated the return on our investment to eliminate bottlenecks to improving health services. more
[Preface]. For more than forty years Primary Health Care (PHC) has been recognized as the cornerstone of an effective and responsive health system. The Alma-Ata Declaration of 1978 reaffirmed the right to the highest attainable level of health, with equity, solidarity and the right to health as its
...
core values. It stressed the need for comprehensive health services, not only curative but services that addressed needs in terms of health promotion, prevention, rehabilitation and treatment of common conditions. A strong resolutive first level of care is the basis for health system development [...] The Pan American Health Organization/World Health Organization (PAHO/WHO) has supported the countries in the establishment of interprofessional PHC teams, in the transformation of health education and in building capacity in the strategic planning, and management of human resources for health. Nursing can play a critical role in advancing PHC. New profiles such as the advanced practice nurses, as discussed in this document, can be fundamental in this effort, and in particular, in health promotion, disease prevention and care, especially in rural and underserved areas.
more
Ce manuel est destiné aux formations sanitaires de base afin qu’elles puissent faire face à la lutte contre la lèpre au Rwanda en s’alignant à la Stratégie mondiale renforcée telle que définie par l’OMS1. Cette stratégie de l’OMS et ses partenaires a pour but de réduire davantage la
...
charge de la lèpre, et fournir des services de qualité pour le traitement de la maladie dans toutes les communautés affectées, tout en garantissant le respect des principes d’équité et de justice sociale.
more
The Health Sector Policy gives general orientations for the sector which are further developed in the various sub-sector policies guiding key health programs and departments. All health sub-sector policies will be updated in line with this new policy. The Health Sector Policy is the basis of nationa
...
l health planning and the first point of reference for all actors working in the health sector. The overall aim of this policy is to ensure universal accessibility (in geographical and financial terms) of equitable and affordable quality health services (preventative, curative, rehabilitative and promotional services) for all Rwandans. It sets the health sector’s objectives, identifies the priority health interventions for meeting these objectives, outlines the role of each level in the health system, and provides guidelines for improved planning and evaluation of activities in the health sector. A companion Health Sector Strategic Plan (HSSP) elaborates the strategic directions defined in the Health Sector Policy in order to support and achieve the implementation of the policy, and more detailed annual operational plans describe the activities under each strategy.
more
Nepal has performed exceptionally in improving reproductive, maternal and child health outcomes over the past two decades. In this article, we discuss these achievements and outline a vision for the future of maternal, newborn and child survival in Nepal after the era of the Millennium Development G
...
oals. On the pathway towards quality universal health care services for all, we propose strengthening of health information systems, gradual health system reforms, improvement of existing facility based services, development of integrated service delivery models, improved technical and managerial capacity at district and facility levels. Elimination of all preventable causes of maternal, newborn and child deaths in Nepal should be our collective aspirational goal.
more
This document describes the key areas that national governments should consider for the introduction and scale-up of point-of-care (POC) diagnostics within national programmes, as new innovative POC technologies are being introduced into the market. The next steps taken to include these new innovati
...
ons within the broader context of national diagnostic networks of conventional laboratories could influence the achievement of the 2030 Fast Track targets for ending the AIDS epidemic.
POC diagnostics, when strategically introduced and integrated into national diagnostic networks, may help catalyse changes that improve the way diagnostics and clinical services are delivered. This document distils this understanding based on programmatic and market experiences of introducing POC diagnostics through catalytic investments in POC HIV technologies across numerous countries in sub-Saharan Africa. more
POC diagnostics, when strategically introduced and integrated into national diagnostic networks, may help catalyse changes that improve the way diagnostics and clinical services are delivered. This document distils this understanding based on programmatic and market experiences of introducing POC diagnostics through catalytic investments in POC HIV technologies across numerous countries in sub-Saharan Africa. more
À l’heure où des techniques innovantes de dépistage sur le lieu de soins (POC) sont mises sur le marché, le présent rapport soumet à l’attention des gouvernements un examen des principaux aspects relatifs à leur introduction et à leur extension au sein des programmes publics nationaux. L
...
’élargissement de la portée de cette stratégie aux réseaux nationaux de dépistage des laboratoires conventionnels contribuerait à la réalisation des objectifs d’accélération de la riposte visant à mettre fin à l’épidémie de sida d’ici à 2030.
Le dépistage sur le lieu de soins, lorsqu’il est stratégiquement mis en place et intégré dans les réseaux nationaux de dépistage, peut contribuer à promouvoir des changements et à améliorer la prestation des services cliniques et de dépistage. Le présent document s’inspire de l’expérience acquise en matière d’introduction, par le biais de financements catalysateurs, de techniques de dépistage sur le lieu de soin dans les programmes et les marchés de nombreux pays d’Afrique subsaharienne pour défendre ce point de vue. more
Le dépistage sur le lieu de soins, lorsqu’il est stratégiquement mis en place et intégré dans les réseaux nationaux de dépistage, peut contribuer à promouvoir des changements et à améliorer la prestation des services cliniques et de dépistage. Le présent document s’inspire de l’expérience acquise en matière d’introduction, par le biais de financements catalysateurs, de techniques de dépistage sur le lieu de soin dans les programmes et les marchés de nombreux pays d’Afrique subsaharienne pour défendre ce point de vue. more
A publication about girls escaping natural disasters and violent conflict in Eastern Africa
Children are on the move. In East Africa region, it is estimated that over 5 million children have migrated across borders or been forcibly displaced in their own country.
Forcable displacement is p ... ushing more and more children out of their homes and communities, escaping the violence of war and conflict, only to fall vulnerable to other forms of violence. Girls are particularly vulnerable and need extra protection.
Every day, girls on the move in East Africa face a variety of rights violations, including:
• Exploitation and violence
• Being separated from their families
• Deprivation of essential services
• Use and recruitment by armed groups
• Sexual abuse
• Child marriage
This report highlights concerns that girls in eastern Africa face and calls on international and national decision makers to prevent and end violence that children face when they are forced to flee their homes. more
Children are on the move. In East Africa region, it is estimated that over 5 million children have migrated across borders or been forcibly displaced in their own country.
Forcable displacement is p ... ushing more and more children out of their homes and communities, escaping the violence of war and conflict, only to fall vulnerable to other forms of violence. Girls are particularly vulnerable and need extra protection.
Every day, girls on the move in East Africa face a variety of rights violations, including:
• Exploitation and violence
• Being separated from their families
• Deprivation of essential services
• Use and recruitment by armed groups
• Sexual abuse
• Child marriage
This report highlights concerns that girls in eastern Africa face and calls on international and national decision makers to prevent and end violence that children face when they are forced to flee their homes. more
According to the Report, cascading and interlinked crises are putting the 2030 Agenda for Sustainable Development in grave danger, along with humanity’s very own survival. The Report highlights the severity and magnitude of the challenges before us. The confluence of crises, dominated by COVID-19,
...
climate change, and conflicts, are creating spin-off impacts on food and nutrition, health, education, the environment, and peace and security, and affecting all the Sustainable Development Goals (SDGs). The Report details the reversal of years of progress in eradicating poverty and hunger, improving health and education, providing basic services, and much more. It also points out areas that need urgent action in order to rescue the SDGs and deliver meaningful progress for people and the planet by 2030.
more
Ce rapport montre que d’importants progrès ont été accomplis en 2015 pour atteindre les cibles de la feuille de route. Ces résultats procèdent de la mise en œuvre de cinq interventions recommandées par l’OMS pour vaincre les MTN : chimiothérapie préventive ; prise en charge innovante et
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intensifiée de la maladie ; écologie et gestion vectorielles ; services de santé publique vétérinaire ; et approvisionnement en eau sans risque sanitaire et services d’assainissement et d’hygiène.
more
There is no guarantee that a successful pilot program introducing a reproductive health innovation can also be expanded successfully to the national or regional level, because the scaling-up process is complex and multilayered. This article describes how a successful pilot program to integrate the S
...
tandard Days Method (SDM) of family planning into existing Ministry of Health services was scaled up nationally in Rwanda.
more
The purpose of the situation assessment was to execute a situation analysis for Autism and Neurodevelopment Disorder (NDD) in Bangladesh. The situation assessment covers the following areas: a review of the scale and prevalence of NDD with trends of the disorder in the recent past in Bangladesh (see
...
page 17); estimation of likely disease burden in the near future (see page 27); assessment of the social response to NDD in Bangladesh (see page 67); overview of the support and services required by persons with NDD (see page 79); an inventory of service providers working with NDD in Bangladesh (see page 85); an assessment of the adequacy of the existing services and support available for addressing NDD in country (see page 97); an overview of the role and preparedness of MOHFW and other stakeholders in addressing NDD in Bangladesh (see page 108); recommendations for monitoring, supervision and reporting mechanisms for NDD services at the national level (see page 167); and recommended key activities that should be undertaken by the Health and other relevant ministries in the short and medium term (see page 167).
more
This publication offers practical advice on implementing HIV and STI programmes for transgender people, with a focus on transgender women, aligned with the 2011 Recommendations and the 2014 Key Populations Consolidated Guidelines. It contains examples of good practice from around the world that may
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support efforts in planning programmes and services, and describes issues that should be considered and how to overcome challenges.
This tool describes how services can be designed and implemented to be acceptable and accessible to transgender women. To accomplish this, respectful and ongoing engagement with them is essential.
This tool gives particular attention to programmes run by transgender people themselves, in contexts where this is possible. more
This tool describes how services can be designed and implemented to be acceptable and accessible to transgender women. To accomplish this, respectful and ongoing engagement with them is essential.
This tool gives particular attention to programmes run by transgender people themselves, in contexts where this is possible. more
CBM’s approach is based on the principles of the UN Convention on the Rights of Persons with Disabilities (CRPD) and on CBM’s responsibility to promote accessibility and the principles of universal design in all spheres of its work, including CBM’s digital content and communications. With this
...
toolkit, we want to provide a guide and practice resource to people working with and for CBM so that together we produce accessible digital content and communications, and place accessibility at the centre of our Information and Communication Technologies (ICT) procurement processes. The toolkit contains a selection of tools for producing accessible content in electronic documents, videos, figures and tools to ensure web accessibility. It also provides tools and information for accessible ICT procurement including tips and resources on how to communicate CBM’s accessibility requirements for products and services being purchased; and how to evaluate what providers promise and deliver.
more
Journal of the International AIDS Society 2017, vol. 20:e25026
In Myanmar, men who have sex with men (MSM) experience high risk of HIV infection. However, access to HIV testing and prevention services remains a challenge among this marginalized ... population. The objective of this study was to estimate population prevalence and correlates of prior HIV testing among young MSM (YMSM) and informs the development of HIV testing and intervention programmes that respond to the specific needs of this population.
https://doi.org/10.1002/jia2.25026 more
In Myanmar, men who have sex with men (MSM) experience high risk of HIV infection. However, access to HIV testing and prevention services remains a challenge among this marginalized ... population. The objective of this study was to estimate population prevalence and correlates of prior HIV testing among young MSM (YMSM) and informs the development of HIV testing and intervention programmes that respond to the specific needs of this population.
https://doi.org/10.1002/jia2.25026 more
Policy Note #1: Myanmar Health Systems in Transition Policy Notes Series
The Government of the Republic of the Union of Myanmar is committed to achieving universal health coverage (UHC) by 2030. In practice, this means that over the next 15 years the aim is to progressively ensure that all peop ... le in all parts of the country have access to the health-care services they need – both preventive and curative – without suffering financial hardship when paying for them.
This policy note is the first in a set of four. It provides an overview of the challenges to be overcome in making progress toward UHC and sets out recommendations for how they can be tackled. The other notes look in more detail at three specific issues: how UHC can improve equity, and how strengthening the township health system and expanding financial risk protection contribute to UHC. more
The Government of the Republic of the Union of Myanmar is committed to achieving universal health coverage (UHC) by 2030. In practice, this means that over the next 15 years the aim is to progressively ensure that all peop ... le in all parts of the country have access to the health-care services they need – both preventive and curative – without suffering financial hardship when paying for them.
This policy note is the first in a set of four. It provides an overview of the challenges to be overcome in making progress toward UHC and sets out recommendations for how they can be tackled. The other notes look in more detail at three specific issues: how UHC can improve equity, and how strengthening the township health system and expanding financial risk protection contribute to UHC. more
Policy Note #3: Myanmar Health Systems in Transition Policy Notes Series
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban areas. For the vast majority of Myanmar’s people, particularly the 70% who reside in rural areas, the ... township health system (THS) is the only government-funded source of preventive, promotive and curative services.
To achieve the national policy objective of progressing towards universal health coverage (UHC) through a primary health-care approach by 2030, the THS is critical to success. It is responsible for the bulk of health care delivery – particularly in rural areas – and is at the heart of national health development in Myanmar. However, if the THS is to be the backbone of health care provision, it currently suffers from a severe case of osteoporosis. more
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban areas. For the vast majority of Myanmar’s people, particularly the 70% who reside in rural areas, the ... township health system (THS) is the only government-funded source of preventive, promotive and curative services.
To achieve the national policy objective of progressing towards universal health coverage (UHC) through a primary health-care approach by 2030, the THS is critical to success. It is responsible for the bulk of health care delivery – particularly in rural areas – and is at the heart of national health development in Myanmar. However, if the THS is to be the backbone of health care provision, it currently suffers from a severe case of osteoporosis. more
Policy Note #4: Myanmar Health Systems in Transition Policy Notes Series
Protecting people from financial hardship when they fall ill is one of the two key elements of universal health coverage (UHC). In practice, this means that the majority of health care costs have to be met from government ... revenues so that services are provided free or with a small affordable co-payment. The alternative is to rely on pre-payment through some form of insurance, where risks are pooled across all contributors.
The challenge in Myanmar is that at present neither approach is functioning. Government spending is too low to meet people’s health needs and the proportion of the population covered by insurance is negligible. As a result, families face a stark choice in the event of serious illness: either defer treatment and face the consequences, or incur what can amount to catastrophic expenses and a downward spiral of disinvestment and poverty. more
Protecting people from financial hardship when they fall ill is one of the two key elements of universal health coverage (UHC). In practice, this means that the majority of health care costs have to be met from government ... revenues so that services are provided free or with a small affordable co-payment. The alternative is to rely on pre-payment through some form of insurance, where risks are pooled across all contributors.
The challenge in Myanmar is that at present neither approach is functioning. Government spending is too low to meet people’s health needs and the proportion of the population covered by insurance is negligible. As a result, families face a stark choice in the event of serious illness: either defer treatment and face the consequences, or incur what can amount to catastrophic expenses and a downward spiral of disinvestment and poverty. more
