DHS Working Papers No. 114
An Examination of 13 Projects in PEPFAR-Supported Countries
You can download the report in Englisch and French. Summaries available in Arabic, Amharic, Dari, Tigrinya, Pashto
Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery ...of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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Pan African Medical Journal 2017;27:215. doi: 10.11604/pamj.2017.27.215.12994
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.
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African Population Studies, Etude de la population africaine vol. 20 n° 2
La sexualité des adolescents est devenue un sujet de préoccupation de santé publique, avec l’extension du SIDA au cours de ces dernières années, particulièrement en milieu urbain.
Quels sont les déterminants des pr...atiques sexuelles des adolescents ? Pourquoi certaines
pratiques peuvent-elles être qualifiées de comportements à risque ? Dans quelles mesures les politiques de santé publique pourront-elles résoudre les problèmes liés à ces pratiques
sexuelles ? C’est pour apporter des éléments de réponse à ces questions que l’enquête sur le comportement sexuel a été menée auprès de 806 adolescents filles et garçons dans la ville de Bangui. Huit discussions de groupes ont été également organisées avec ces adolescents et leurs parents.
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Accessed on 03.03.2020
Cet article documente le processus de mise en œuvre du Traitement préventif intermittent TPI), une stratégie de prévention du paludisme dont l’administration est couplée au Programme élargi de vaccination (PEV) dans les services de santé, les réactions des prestat...aires, des populations et leurs facteurs explicatifs. Les résultats montrent que l’absence de connaissances adéquates à propos du TPI n’a pas empêché son appropriation par les communautés, dans la mesure où les perceptions lui accordent une valeur pratique et l’intègrent dans les besoins ressentis. C’est pourquoi les enfants ont reçu, dans la grande majorité, les médicaments administrés. Certains comportements en décalage s’expliquent plus par des contraintes, des insuffisances du système de santé et de vaccination que par un refus. Chez les prestataires de soins, l’information a été plus disponible du côté les infirmiers étatiques. Cependant, les processus de détournement et les attitudes d’indifférence étaient plus visibles chez ces derniers.
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It is often observed that educated women have lower birth rates than do the less educated, inviting a causal interpretation. However, educated women also differ from those who have never attended school in a
variety of other ways: the two factors are multiply related. This article analyzes the rela...tionship between schooling and fertility in contemporary Cameroon as both a statistical and a social phenomenon, using data from the 1998 Cameroon DHS alongside ethnographic field data collected by
the author. T
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This guidance is intended to be used by programme managers following the decision to introduce human papillomavirus (HPV) virological testing as a screening assay in their national cervical cancer prevention and control programme. The guidance includes a step-by-step process to be followed after the... decision has been made to specifically introduce and/or scale-up HPV virological testing for screening, which would be followed up with adequate management within the context of cervical cancer prevention
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Lancet Glob Health 2020Published OnlineDecember 10, 2020 https://doi.org/10.1016/S2214-109X(20)30460-5
Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of care for critically ill patients, especially in low-staffed and low-resourced settings, and mortal...ity rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
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This document sets out, therefore, to explain the socioeconomic value of investing in the fight against NTDs and highlights priorities for global investment attention. Our work was guided by the need not only for
additional funding and funders but also for the need to understand the current funding... climate, in which value for money and the efficient use of resources to fill the most critical of gaps are more relevant than ever.
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This perspective draws on the record of ancient pathogengenomes and microbiomes illuminating patterns of infectious disease over the course of the Holocene in order toaddress the following question. How did major changes inliving circumstances involving the transition to and intensification of farmi...ng alter pathogens and their distributions? Answers to this question via ancient DNA researchprovide a rapidly expanding picture of pathogen evolution and in concert with archaeological and historical data, give a temporal and behavioral context for heath in the past that is relevant for challenges facing the world today, including the rise of novel pathogens.
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Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nationally representative data on the current patterns... of treatment coverage. The objectives of this study were to estimate the proportion of adults with diabetes in LMICs who receive coverage of recommended pharmacological and non-pharmacological diabetes treatment; and to describe country-level and individual-level characteristics that are associated with treatment.
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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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Despite recent global declines, under-five mortality remains high in many of the poorest countries. Barriers to timely
quality care, including user fees, distance to facilities and the availability of trained health workers and medical supplies,
hinder progress in further reducing morbidity and m...ortality
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