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2
In the WHO South-East Asia Region, epidemiological knowledge of mental health conditions remains
a relative unknown, given the sparsity of data and information on (a) the total burden associated
w
...
ith each disorder; (b) the degree of met and unmet needs for treatment and interventions; and
(c) the patterns and costs of treatment. This is a common situation in other regions of the world,
where the global descriptive epidemiology of the Global Burden of Disease (GBD) study is mainly
used in association with the WHO Global Health Estimates (GHE) to quantify, at the very least, the
total burden associated with mental health conditions.
more
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 change
...
s vary substantially across countries, even at similar 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
Global health funding has increased in recent years. This has been accompanied by a proliferation in the number of global health actors and initiatives. This paper describes the state of global heat
...
h finance, taking into account government and private sources of finance, and raises and discusses a number of policy issues related to global health governance. A schematic describing the different actors and three global health finance functions is used to organize the data presented, most of which are secondary data from the published literature and annual reports of relevant actors.
more
Over the past two decades, China has become a distinctive and increasingly important donor of development assistance for health (DAH). However, little is known about what factors influence China’s priority-setting for DAH. In this study, we provid
...
e an updated analysis of trends in the priorities of Chinese DAH and compare them to comparable trends among OECD Development Assistance Committee (DAC) donors using data from the AidData’s Global Chinese Development Finance Dataset (2000–2017, version 2.0) and the Creditor Reporting System (CRS) database (2000–2017). We also analyse Chinese medical aid exports before and after the start of the COVID-19 pandemic using a Chinese Aid Exports Database.
more
The Global status report on alcohol and health and treatment of substance use disorders presents a comprehensive overview of alcohol consumption, alcohol-related harm and policy responses as well as treatment capacities for alcohol and drug use diso
...
rders worldwide. The report is based on data collected by WHO from Member States and organized in accordance with the Sustainable Development Goals health target 3.5 which calls on countries to strengthen “the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol”. The chapter on alcohol and health continues the series of WHO global status reports on alcohol and health and presents the latest available data on the status of, and trends in, alcohol consumption, as well as estimates of the alcohol-attributable disease burden and descriptions of policy responses worldwide. On the basis of data collected from countries on the treatment of substance use disorders the report describes the status of key components of treatment responses to alcohol and drug use disorders and proposes a new service capacity index for these disorders as an additional contextual indicator for monitoring progress in this domain of SDG health target 3.5. The report concludes with broad directions for international action to accelerate progress towards achievement of SDG health target 3.5.
more
The Disability inclusion guide for action supports ministries of health and their partners in both advancing health equity for persons with disabilities by identifying entry points, and planning app
...
ropriate actions that strengthen the health system through disability inclusion. It focuses on addressing the contributing factors which relate to the health system – namely, the attitudinal,
institutional, and physical barriers faced by persons with disabilities across all health system building blocks. Such factors include the exclusion of persons with disabilities in governance and decision-making processes in the health sector; gaps in knowledge, negative attitudes, and discriminatory practices among the health and care workforce; inaccessible physical infrastructure, health
information and communication; and a lack of information or data collection and analysis on disability in monitoring and evaluation in the health system.
more
In the last three decades, health financialization has surged in
several creative ways, yet this growing phenomenon remains surprisingly
unknown, and neglected, in the global health arena. Financi
...
alization in the
health domain could be described as the uncontrolled expansion of finance along various lines of healthcare provision. Health has been intentionally transformed into a commodity as private for-profit actors have been allowed freedom to operate - and ultimately play with people’s fundamental right to health - for their vested financial interests, nationally and internationally. Health financialization is thrivingly pursued today for example through the institutionalization of medical knowledge monopolies, the expansion of markets and of financial techniques applied to healthcare insurance schemes, the soaring digitalization of global health interventions and the booming data industry.
more
Rising levels of inflation, debt and macrofiscal tightening are putting expenditures on the social sectors including health under immense scrutiny. Already, there are worrying signs of reductions in social sector investments. However, even before th
...
e pandemic, evidence showed the significant returns on investments in health equity and its social determinants. Emerging data and trends show that these potential returns have increased during the COVID-19 pandemic - investments in social determinants can mitigate widespread reductions in human capital and the increasing likelihood of costly syndemics, while promoting access to healthcare innovations that have thus far been inequitably distributed. Therefore, we argue that, despite immediate fiscal pressures, this is exactly the time to invest in health equity and its broader social determinants, as the returns on such investments have never been greater.
more
This is only the cover of the book. Download the whole Toolkit at: www.cdc.gov/reproductivehealth/Refugee/
Understanding the reproductive health needs of conflict-affected women will enable organizations to implement and enhance programs and se
...
rvices to improve the health of women and their families. The Reproductive Health Assessment Toolkit (RHA) for Conflict-Affected Women provides user-friendly tools to quantitatively assess the reproductive health needs of conflict-affected women aged 15–49 years. The RHA Toolkit enables field staff to collect data to inform program planning, monitoring, evaluation, and advocacy. It promotes using the collected data to enhance services and improve the reproductive health of women and their families.
more
Improving the quality of care for mothers and newborns in health facilities: learner's manual. Version 02.
World Health Organization (WHO), Regional Office for South-East Asia
WHOCC AIIMS, UNICEF, UNFPA and USAID
(2017)
C_WHO
A training package for building capacity of healthcare teams in health facilities for continous quality improvement of maternal and newborn healthcare. The focus is on the care of mothers and newborns at the time of child birth since a large proport
...
ion of maternal deaths, newborn deaths and stillbirths happen around that time.
The 4-Step POCQI (Point of care Quality Improvement) package includes Coaching manual and Learner manual that present a demystified and simple model of quality improvement at the level of health facilities using local data to identify quality gaps, analyse underlying causes and improve health care practices in their own specific context without much additional resources.
more
No Public Health without Refugee and Migrant health.
This report, the first of its kind, creates an evidence base with the aim of catalysing progress towards developing and promoting migrant-sensit
...
ive health systems in the 53 Member States of the WHO European Region and beyond. This report seeks to illuminate the causes, conse-quences and responses to the health needs and challenges faced by refugees and migrants in the Region, while also providing a snapshot of the progress being made across the Region. Additionally, the report seeks to identify gaps that require further action through collaboration, to improve the collection and availability of high-quality data and to stimulate policy initiatives
more
This Community Health Systems (CHS) Catalog country profile is the 2016 update of a landscape
assessment that was originally conducted by the Advancing Partners & Communities (APC) project
in 2014. The CHS Catalog focuses on 25 countries deemed pr
...
iority by the United States Agency for
International Development’s (USAID) Office of Population and Reproductive Health, and includes
specific attention to family planning (FP), a core focus of the APC project.
The update comes as many countries are investing in efforts to support the Sustainable Development
Goals and to achieve universal health coverage while modifying policies and strategies to better align
and scale up their community health systems.
The purpose of the CHS Catalog is to provide the most up-to-date information available on community
health systems based on existing policies and related documentation in the 25 countries. Hence, it does
not necessarily capture the realities of policy implementation or service delivery on the ground. APC
has made efforts to standardize the information across country profiles, however, content between
countries may vary due to the availability and quality of the data obtained from policy documents.
more
The chapter Closing the Gap: The Health Disparities of Older LGBTI People in the Americas, is part of the publication series titled ‘Decade of Healthy Aging: situation and challenges’. In order to outline the current knowledge available on the s
...
ituation of health and well-being of older persons in the Americas at the beginning of the United Nations Decade of Healthy Aging (2021-2030), this document presents data and existing evidence different forms of discrimination and mistreatment older people face due to their sexual orientation and gender identities that ultimately increase health disparities. Previous studies on LGBTI older people offer valuable information on the lived experiences of these communities and demonstrate that they face unique challenges with aging, emphasizing the difficulties related to access to care. Very few studies on older people and aging include a focus on sexual orientation or gender identity; however, it is possible to point out that HIV/AIDS is one of the most significant health disparities confronting LGBTI older persons, followed by physical and mental health problems, substance use, social isolation, poverty, and the lack of access to quality healthcare, including long-term care facilities or other institutions. Closing the gap in access and quality of health and care services is an imperative to increase longevity, health status and quality of life of LGBTI older people.
more
The World Health Organization (WHO) is releasing the second edition of its Global Accelerated Action for the Health of Adolescents (AA-HA!) guidance. The document aims to equip governments to respon
...
d to the health and well-being challenges, opportunities and needs of adolescents.
The guidance provides the latest available data on adolescent health and well-being. It also outlines an updated list of core indicators that data should be collected on. Globally, road injury was the top cause of death for adolescent males in 2019. Among female adolescents, the leading causes of death were diarrhoeal diseases among the younger group (10-14 years) and tuberculosis (TB) in the older group (15-19 years).
Over the last 20 years, mortality rates have declined among adolescents globally, with the largest decline in older (15–19 years) adolescent girls. For non-fatal diseases, the burden has not improved over the past two decades, with the main causes of ill health in this category being: mental health conditions (depressive and anxiety disorders, childhood behavioural disorders), iron deficiency anaemia, skin diseases and migraine.
Adolescent well-being depends on a range of factors, including healthy food, education, life skills and employability, connectedness, feeling valued by society, safe and supportive environments, resilience, and the freedom to make choices. To take an appropriately holistic approach, the guidance outlines how to take crosscutting action to support adolescent health and well-being, with mutually reinforcing interventions across sectors, such as health, education, social protection, and telecommunications. Targeted efforts are also required to engage adolescents, as they trust health systems less than adults do and are especially vulnerable to modern-day trends, like online bullying and gaming.
more
Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health car
...
e system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how they view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
more
Background: A recent report by the Institute for Health Metrics and Evaluation (IHME) highlights that mental health receives little attention despite being a major cause of disease burden. This pape
...
r extends previous assessments of development assistance for mental health (DAMH) in two significant ways; first by contrasting DAMH against that for other disease categories, and second by benchmarking allocated development assistance against the core disease burden metric (disability-adjusted life year) as estimated by the Global Burden of Disease Studies. Methods: In order to track DAH, IHME collates information from audited financial records, project level data, and budget information from the primary global health channels. The diverse set of data were standardised and put into a single inflation adjusted currency (2015 US dollars) and each dollar disbursed was assigned up to one health focus areas from 1990 through 2015. We tied these health financing estimates to disease burden estimates (DALYs) produced by the Global Burden of Disease 2015 Study to calculated a standardised measure across health focus areas—development assistance for health (in US Dollars) per DALY.
more
The guide to implementing the One Health Joint Plan of Action (OH JPA) at national level provides practical guidance on how countries can adopt and adapt the OH JPA to strengthen and support national One H
...
ealth action.
Building on the OH JPA theory of change, this guide describes three pathways and five key steps to implement the OH JPA at national level:
Pathway 1 -- Governance, policy, legislation, financing and advocacy
Pathway 2 -- Organizational and institutional development, implementation and sectoral integration
Pathway 3 -- Data, evidence, information systems and knowledge exchange.
The stepwise approach comprises:
Situation analysis including stakeholder mapping and review of existing assessment results
Set-up/strengthening of a multisectoral, One Health coordination mechanism
Planning for implementation, including activity prioritization and leveraging of resources
Implementation of national One Health action plans
Review, sharing and incorporation of lessons learned.
more
2nd edition
WASH FIT is a risk-based, continuous improvement framework with a set of tools for undertaking water, sanitation and hygiene (WASH) improvements as part of wider quality improvements in health care facilities. It is aimed at small prima
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ry, and in some instances secondary, health care facilities in low and middle income countries.
An app, for front line data collection is also available in the Android Google Play store or as a web app
more
DHS Further Analysis Reports No. 108 - This report examines levels, trends, and inequalities in maternal health in Rwanda from 2010 to 2014-15 among women age 15-49 with a recent birth. The analysis uses Demographic and
...
Health Survey (DHS) data for 15 key indicators of maternal health: 6 for antenatal care, 3 for delivery, 1 for postnatal care, and 5 for barriers to accessing medical care. Levels and trends in these indicators were analyzed overall and by three background characteristics: women’s education, household wealth quintile, and region.
more
In this entry we are looking at smoking, alcohol consumption and the use of illicit drugs. We are studying who is using these substances, how their use has changed over time, and we are presenting the estimates of their impact on health. Collectivel
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y, smoking, alcohol and illicit drug use kills 11.8 million people each year. This is more than the number of deaths from all cancers
more
