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Arlington, Virginia, Partnership for Child Health Care, 1995.  p. (BASICS Trip Report; BASICS Technical Directive: 000 HT 51 012; USAID Contract No. HRN-6006-C-00-3031-00)A specialist of vaccine vial monitors (VVMs) assisted in developing the agenda for and participated in a meeting in Geneva designed to develop plans for introducing VVMs on oral polio vaccine (OPV). Representatives of the World Health Organization (WHO) Global Programme on Vaccines and Immunization (GPV), the US Agency for International Development (USAID), UNICEF, and Basic Support for Institutionalizing Child Support Project (BASICS)/ Program for Appropriate Technology in Health (PATH) participated in the discussions. The meeting served to update all agencies involved with OPV delivery about VVMs and to identify what actions are needed as well as the parties responsible for the global introduction of vaccines with VVMs. In the summer of 1995, Tanzania will be hosting a pilot project of introducing VVMs with OPVs. Other potential pilot sites include Swaziland and Vietnam. Discussion of pilot activities focused on their purpose, resources available for establishing and monitoring them, and the appropriate number of pilot countries. There were also discussions of a framework for global introduction of VVMs, potential costs associated with VVMs, the effect on vaccine forecasting, and training materials. There were sessions on the organization of the GPV, vaccine supply and quality, the view from Sudan and Indonesia, and human and financial resources. Meeting participants agreed on follow-up actions: continue to work with international OPV supplies, begin to approach national OPV producers to lay the groundwork for use beginning in 1996, limit pilot activities to 4-5 countries (1-2 countries only receiving a packet of information and no technical assistance), develop a package of introduction materials, and develop a briefing sheet on VVMs.
Arlington, Virginia, John Snow, Inc. [JSI], Resources for Child Health Project [REACH], 1986 Jun. , 31,  p. (USAID Contract No. DPE-5927-C-00-5068-00)In the mid 1980s, the Government of The Gambia (GOTG) sought funds from the World Bank and other donors to restructure and strengthen its health system. Since the World Bank thought that recurrent cost obligations that the GOTG would find unacceptable should accompany the implementation of the National Health Project (NHP), this study was undertaken. The Italian Government agreed to fund US $9.8 million to NHP, most of the funds going to renovating and refurbishing the pediatric ward and central laboratory at Royal Victoria Hospital in Banjul. Trends in health sector expenditures showed that the devaluation of the dalasi continued to bring about shortfalls in nonsalary costs, especially in drugs and dressings. Therefore the GOTG must address the shortfalls before even considering expansion of the already inefficient health delivery system. It also needs to develop a cost recovery system for drugs which maintains a reliable source and adequate supplies of drugs in the proper amounts, effectively distributes the drugs, and manages the finances effectively. The GOTG should also develop the Ministry of Health's ability to coordinate donor support and to develop a process of budgeting, spending, and planning. The study team also recommended consolidating staff rather than expand staff in light of financial constraints. A flotation policy and exchange rates less favorable to the dalasi may grant the GOTG more access to exchange within the banking system.