Impact Evalution Report 61
3ie Impact Evaluation Report 39
10 years after the UN general assembly special session on drugs
From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the lit...erature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and people’s access to and use of them in LMICs, where historic and ongoing under-investments heighten vulnerability to a multiplicity of health threats. We use the term ‘vertical response’ to describ...e decisions, measures and actions taken solely with the purpose of preventing and containing COVID-19, often without adequate consideration of how this affects the wider health system and pre-existing resource constraints.
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The COVID-19 pandemic and subsequent public health guidance to reduce the spread of the diseasehave wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergency departments(EDs) have rapidly adapted provision of care in response to the pandemic. This qualitativ...e study utilized insight frommultidisciplinary frontline staff to understand the changes in paediatric emergency healthcare utilization duringCOVID-19 the experiences of working within the restructured health system.
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Background paper 8
The Independent Panel for Pandemic Preparedness and Response
May 2021
- Module 1: Understanding modelling approaches for sexual, reproductive, maternal, newborn, child and adolescent health, and nutrition
Coronavirus disease 2019 (COVID-19) has a wide range of documented effects. It directly causes death and disability for some people infected. However, disruption to... essential health services, resources allocated to mitigation and therefore away from essential health service delivery, and the overall impact on the economy and society must also be considered within the response to COVID-19. Understanding the magnitude of all of these effects is an essential part of developing mitigation polices.
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVID-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
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BMC Public Health (2021) 21:299 https://doi.org/10.1186/s12889-021-10296-9
The Impacts of Climate Change on Human Health
in the United States: A Scientific Assessment
Climate change is a significant threat to the health of the American people. This scientific assessment examines how climate change is already affecting human health and the changes that may occur in the fu...ture.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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The Royal College of Paediatrics and Child Health recognises that climate change
is an existential threat to the health and wellbeing of children and young people.
In October 2020, we joined national health and academic alliances to declare
climate change an emergency requiring accelerated col...laborative actions. This
position statement summarises our recommendations and activity about
mitigation and adaptation against the impact of climate change on children and
young people around the world.
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PlosOne https://doi.org/10.1371/journal.pone.0165797; Food production is a major driver of greenhouse gas (GHG) emissions, water and land use, and dietary risk factors are contributors to non-communicable diseases. Shifts in dietary patterns can therefore potentially provide benefits for both the en...vironment and health. However, there is uncertainty about the magnitude of these impacts, and the dietary changes necessary to achieve them.
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The new review paper, The Impacts of Climate Change on Health, identifies the extent to which increasing emissions, extreme weather and temperatures elevate health risks, from infectious disease to malnutrition, and assesses the associated health burden. It concludes that the health burden will exce...ed the level of demand that health systems are prepared for.
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BackgroundClimate change is one of the great challenges of our time. The consequences of climate change on exposed biological subjects, as well as on vulnerable societies, are a concern for the entire scientific community. Rising temperatures, heat waves, floods, tornadoes, hurricanes, droughts, fir...es, loss of forest, and glaciers, along with disappearance of rivers and desertification, can directly and indirectly cause human pathologies that are physical and mental.
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The climate crisis has many consequences – among them widespread health impacts that will lead to immense societal, ecological, and economic harm.
Over the past two decades multiple large-scale reviews on climate change and health have made clear the need for a multi-sectoral approach to target t...he drivers and impacts of climate change, biodiversity loss, and ecosystem degradation. Despite this abundance of scientific evidence underscoring urgency of action, policy implementation responses lag behind. Even at COP26, itself delayed due to an ongoing pandemic, health continues to be considered by many countries a problem independent from climate and environment.
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PlosOne May 7, 2012 https://doi.org/10.1371/journal.pone.0036735 ; Safe drinking water is critical for health. Household water treatment (HWT) has been recommended for improving access to potable water where existing sources are unsafe. Reports of low adherence to HWT may limit the usefulness of thi...s approach, however.
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Food security, human health and wellbeing largely depend on biodiversity. Biodiversity supports agriculture through ecosystem services such as pollination and water purification, and provides access to natural medicines,
which are the primary source of health care for 4 billion people worldwide
The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 20...30, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
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