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Washington, D.C., World Bank, 2005.  p. (World Bank Working Paper No. 68)In recent years, Europe and Central Asia has experienced the world’s fastest growing HIV/AIDS epidemic. Yet, in the Western Balkan countries the HIV prevalence rate is under 0.1 percent, which ranks among the lowest. This may be due to a low level of infection among the population—or partly due to inadequate surveillance systems. All major contributing factors for the breakout of an HIV/AIDS epidemic are present in the Western Balkans. HIV/AIDS disproportionably affects youth (80 percent of HIV-infected people are 30 years old or younger). Most of the Western Balkan countries have very young populations, which have been affected by the process of social transition, wars, unemployment and other factors. Among youth, there is generalized use of drugs and sexual risk behavior. Therefore, the number of cases of HIV has been increasing, especially in Serbia, and the incidence of Hepatitis C has clearly increased, which suggests that sharing of infected needles is practiced by injecting drug users. Apart from human suffering, an HIV/AIDS epidemic can have a significant impact on costs of care for individuals, households, health services and society as a whole. This study has found weak public health systems and gaps in financing and institutional capacity necessary to implement evidence-based and cost-effective HIV/AIDS Strategies. Political commitment must increase for action to occur promptly. Prevention interventions are cost effective and, in the short term, affordable with own-country resources. Medium- and long-term interventions would require donor assistance. Longer-term interventions would aim at preventing poverty, exclusion and unemployment, for example, by empowering young people to participate in the regional and global labor market.
Global Call to Action: Maximize the public health impact of intermittent preventive treatment of malaria in pregnancy in sub-Saharan Africa.
Malaria Journal. 2015; 14:207.Intermittent preventive treatment of malaria in pregnancy is a highly cost-effective intervention which significantly improves maternal and birth outcomes among mothers and their newborns who live in areas of moderate to high malaria transmission. However, coverage in sub-Saharan Africa remains unacceptably low, calling for urgent action to increase uptake dramatically and maximize its public health impact. The ‘Global Call to Action’ outlines priority actions that will pave the way to success in achieving national and international coverage targets. Immediate action is needed from national health institutions in malaria-endemic countries, the donor community, the research community, members of the pharmaceutical industry and private sector, along with technical partners at the global and local levels, to protect pregnant women and their babies from the preventable, adverse effects of malaria in pregnancy © 2015 Chico et al. Open Access.
Community health care: Bringing health care at your door. Report of side event at 67th World Health Assembly.
[Geneva, Switzerland], World Health Organization [WHO], Global Health Workforce Alliance, 2014.  p.The side event held at the 67th World Health Assembly provided an opportunity to deliberate on integrated community health care (CHC) in attaining the Millennium Development Goals (MDGs) and Universal Health Coverage (UHC). The session also explored effective policies and strategies that could be used to remove the obstacles to deliver quality health care and positioning community health workers (CHWs) as an integral part of local health teams.
Making fair choices on the path to universal health coverage. Final report of the WHO Consultative Group on Equity and Universal Health Coverage.
Geneva, Switzerland, WHO, 2014.  p.Universal health coverage (UHC) is at the center of current efforts to strengthen health systems and improve the level and distribution of health and health services. This document is the final report of the WHO Consultative Group on Equity and Universal Health Coverage. The report addresses the key issues of fairness and equity that arise on the path to UHC. As such, the report is relevant for every actor that affects that path and governments in particular, as they are in charge of overseeing and guiding the progress toward UHC.
Multilateral, regional, and national determinants of policy adoption: the case of HIV/AIDS legislative action.
International Journal of Public Health. 2013 Apr; 58(2):285-93.OBJECTIVES: This article examines the global legislative response to the HIV/AIDS epidemic with a particular focus on how policies were diffused internationally or regionally, or facilitated internally. METHODS: This article uses event history analysis combined with multinomial logit regression to model the legislative response of 133 countries. RESULTS: First, the results demonstrate that the WHO positively influenced the likelihood of a legislative response. Second, the article demonstrates that development bank aid helped to spur earlier legislative action. Third, the results demonstrate that developed countries acted earlier than developing countries. And finally, the onset and severity of the HIV/AIDS epidemic was a significant influence on the legislative response. CONCLUSION: Multilateral organizations have a positive influence in global policy diffusion through informational advocacy, technical assistance, and financial aid. It is also clear that internal stressors play key roles in legislative action seen clearly through earlier action being taken in countries where the shock of the onset of HIV/AIDS occurred earlier and earlier responses taken where the epidemic was more severe.
American Journal of Public Health. 2013 Apr; 103(4):623-31.The low priority that most low-income countries give to neonatal mortality, which now constitutes more than 40% of deaths to children younger than 5 years, is a stumbling block to the world achieving the child survival Millennium Development Goal. Bangladesh is an exception to this inattention. Between 2000 and 2011, newborn survival emerged from obscurity to relative prominence on the government's health policy agenda. Drawing on a public policy framework, we analyzed how this attention emerged. Critical factors included national advocacy, government commitment to the Millennium Development Goals, and donor resources. The emergence of policy attention involved interactions between global and national factors rather than either alone. The case offers guidance on generating priority for neglected health problems in low-income countries.
Contemporary Politics. 2012 Jun; 18(2):186-199.Capacity-building has become a mainstay of many AIDS and public health programmes. This article examines its impact on civil society organisations and claims-making around citizenship, as these have been articulated through heterogeneous policy networks doing HIV prevention work. Drawing on a growing literature on the Foucauldian notions of biopower and governmentality, the genealogy of capacity-building as a globalised technology of governmentality is traced, examining its uses both at the international level and in Brazil. Brazilian civil society organisations have undoubtedly been transformed by their participation in networks carrying out capacity-building projects. While recognising these effects, the conflicts and productive tensions inherent to such networks are highlighted.
Guidance for evidence-informed policies about health systems: Linking guidance development to policy development.
PLoS Medicine. 2012 Mar; 9(3):e1001186.Contextual factors are extremely important in shaping decisions about health systems, and policy makers need to work through all the pros and cons of different options before adopting specific health systems guidance. A division of labour between global guidance developers, global policy developers, national guidance developers, and national policy developers is needed to support evidence-informed policy-making about health systems. A panel charged with developing health systems guidance at the global level could best add value by ensuring that its output can be used for policy development at the global and national level, and for guidance development at the national level. Rigorous health systems analyses and political systems analyses are needed at the global and national level to support guideline and policy development. Further research is needed into the division of labour in guideline development and policy development and on frameworks for supporting system and political analyses. This is the second paper in a three-part series in PLoS Medicine on health systems guidance.
Food and Nutrition Bulletin. 2011 Jun; 32(2 Suppl):S115-27.BACKGROUND: Renewed Efforts Against Child Hunger (REACH) is the joint United Nations initiative to address Millennium Development Goal (MDG) 10, Target 3, i.e., to halve the proportion of underweight children under 5 years old by 2015. The United Nations Food and Agriculture Organization (FAO), the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the World Food Programme (WFP), and the International Fund for Agricultural Development (IFAD) developed and tested a facilitation mechanism to act as a catalyst for scaling up multisectoral nutrition activities. OBJECTIVE: The UN-REACH partners developed pilot projects in Mauritania and Lao PDR from 2008 to 2010 and deployed facilitators to improve nutrition governance and coordination. Review missions were conducted in February 2011 to assess the REACH approach and what it achieved. METHODS: The UN review mission members reviewed documents, assessed policy and management indicators, conducted qualitative interviews, and discussed findings with key stakeholders, including the most senior UN nutrition directors from all agencies. RESULTS: Among other UN-REACH achievements, the Prime Minister of Mauritania agreed to preside over a new National Nutrition Development Council responsible for high-level decision-making and setting national policy objectives. REACH facilitated the completion of Lao's first national Nutrition Strategy and Plan of Action and formation of the multistakeholder Nutrition Task Force. During the REACH engagement, coordination, joint advocacy, situation analysis, policy development, and joint UN programming for nutrition were strengthened in Lao PDR and Mauritania. CONCLUSIONS: Improvements in the nutrition governance and management mechanisms in Mauritania and Lao PDR were observed during the period of REACH support through increased awareness of nutrition as a key development objective, establishment of governmental multisectoral coordinating mechanisms, improved government capacity, and new joint UN-government nutrition programming.
MCN. American Journal of Maternal/Child Nursing. 2010 Jan-Feb; 35(1):63.The purpose of this article is to describe recent initiatives designed to improve outcomes for Bolivian women and children. It discusses the high infant and maternal mortality rates of Bolivia and stresses the importance of the international community partnering with the Bolivian government and healthcare personnel to provide support and assistance in a coordinated fashion to make a difference in the health and well-being of women and children.
From advocacy to access: Bangladesh. 360 degrees advocacy: Strengthening a weak contraceptive supply chain in Bangladesh. Fact chart.
London, England, IPPF, 2009 Nov.  p.In Bangladesh, the IPPF Member Association, the Family Planning Association of Bangladesh (FPAB), worked with the Ministry of Health and Family Welfare to improve the dysfunctional supply chain. Results to date include: The Ministry of Health reactivated the Logistical Coordination Forum, a donor, government and civil society led group, to identify and solve blockages in the supply chain; Capacity building and training for staff in the Logistics and Supply Unit were increased; The Ministry of Health and Family Welfare committed to using government resources to make up the shortfall from declining donor contributions.
Washington, D.C., The National Academies Press, 2008 Dec 15.  p.At this historic moment, the incoming Obama administration and leaders of the U.S. Congress have the opportunity to advance the welfare and prosperity of people within and beyond the borders of the United States through intensified and sustained attention to better health. The United States can improve the lives of millions around the world, while reflecting America's values and protecting and promoting the nation's interests. The Institute of Medicine-with the support of four U.S. government agencies and five private foundations-formed an independent committee to examine the United States' commitment to global health and to articulate a vision for future U.S. investments and activities in this area.
Lancet. 2007 Oct 27; 370(9597):1471-1474.With the Paul Wolfowitz era behind it and new appointee Robert Zoellick at the helm, it is time for the World Bank to better define its role in an increasingly crowded and complex global health architecture, says Jennifer Prah Ruger, health economist and former World Bank speechwriter. Just 2 years after taking office as president of the World Bank, Paul Wolfowitz resigned amid allegations of favouritism, and is now succeeded by Robert Zoellick. Many shortcomings marked Wolfowitz's presidency, not the least of which were a tumultuous battle over family planning and reproductive health policy, significant reductions in spending and staffing, and poor performance in implementing health, nutrition, and population programmes. Wolfowitz did little to advance the bank's role in the health sector. With the Wolfowitz era behind it and heightened scrutiny in the aftermath, the World Bank needs to better define its role and seize the initiative in health at both the global and country levels. Can the bank have an effect in an increasingly plural and complex global health architecture? What crucial role can the bank play in global health governance in the years ahead? (excerpt)
The Global Campaign for the Health MDGs: Challenges, opportunities, and the imperative of shared learning.
Lancet. 2007 Sep 22; 370(9592):1018-1020.On Sept 5, the International Health Partnership (IHP) was launched by the UK, and on Sept 26, Women and Children First: the Global Business Plan for Maternal, Newborn and Child Health will be launched by Norway. These two new efforts, along with the Canadian Catalytic Initiative to Save a Million Lives, have been packaged as part of a broader Global Campaign for the Health Millennium Goals (MDGs). Such an explosion of proposals, which is meant to accelerate action for achieving MDGs 4, 5, and 6, should be welcomed by the world's health community. The proposals are further recognition of the continued commitment by high-income countries to address key health challenges in low-income and middle-income countries. Building on a decade of expanding work in global health, we can hope that these high-profile initiatives will sustain interest and address major obstacles to improving the health of the poorest people in the magnitude and time-frame demanded by the MDGs. Nevertheless, as is often the case with new policy efforts, the main operative aspects of the proposals and their likely consequences can be difficult to identify. We frame questions on five key issues that these announcements highlight. (excerpt)
Bulletin of the World Health Organization. 2007 Mar; 85(3):192-199.International health policy-makers now have a variety of institutional instruments with which to pursue their global and national health goals. These instruments range from the established formal multilateral organizations of the United Nations to the newer restricted-membership institutions of the Group of Eight (G8). To decide where best to deploy scarce resources, we must systematically examine the G8's contributions to global health governance. This assessment explores the contributions made by multilateral institutions such as the World Health Organization, and whether Member States comply with their commitments. We assessed whether G8 health governance assists its member governments in managing domestic politics and policy, in defining dominant normative directions, in developing and complying with collective commitments and in developing new G8-centred institutions. We found that the G8's performance improved substantially during the past decade. The G8 Member States function equally well, and each is able to combat diseases. Compliance varied among G8 Member States with respect to their health commitments, and there is scope for improvement. G8 leaders should better define their health commitments and set a one-year deadline for their delivery. In addition, Member States must seek WHO's support and set up an institution for G8 health ministers. (author's)
Choices. 2001 Dec; 5.The HIV/AIDS epidemic is the world's most serious development crisis. Nearly 58 million people have been infected, and 22 million are already dead. The epidemic continues to spread, with over 15,000 new infections every day. The devastating scale and impact of this catastrophe is a call of the utmost urgency for each of us to act. On 27 June 2001, the United Nations General Assembly Special Session on HIV/AIDS (UNGASS), adopted the "Declaration of Commitment on HIV/ AIDS." The Declaration recognized in clear and forthright terms the driving forces of the epidemic, including social, economic, and cultural aspects; and set specific measurable goals in four key areas: prevention of new infections; provision of improved care, support and treatment; reduction of vulnerability; and mitigation of the socio-economic impact of HIV/AIDS. The global community is challenged to respond to the epidemic in a new way, with strategic attention to its human rights and gender dimensions, greater accountability for results, and courageous and visionary leadership. (excerpt)
Malaria treatment policy: technical support needs assessment. Malaria Action Coalition (MAC) Senegal Mission report, March 14-21, 2005.
Arlington, Virginia, Management Sciences for Health [MSH], Rational Pharmaceutical Management Plus, 2005. 18 p. (USAID Cooperative Agreement No. HRN-A-00-00-00016-00; USAID Development Experience Clearinghouse DocID / Order No. PN-ADF-437)African countries are undergoing a period of dramatic change in their national malaria treatment policies as more of these countries adopt artemisinin-based combination therapy (ACT). Successful implementation of the new ACT policies presents many challenges and most countries will require technical assistance from a variety of sources, both internal and external. The Malaria Action Coalition (MAC) partnership brings together three partners that have considerable expertise in many of the areas related to ACT implementation, which complements expertise brought by other Roll Back Malaria (RBM) partners. The U.S. Agency for International Development (USAID) has made a commitment to the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) to provide technical assistance through MAC. This mission was therefore designed to assess the progress of Senegal toward implementing the new ACT policy and to determine what, if any, additional technical support it may need to successfully complete the implementation. It is expected that the successful implementation of the ACT policy will contribute to the attainment of the RBM goals for the prevention, treatment, and control of malaria in sub-Saharan Africa through coordinated technical support. (excerpt)
Adolescence Education Newsletter. 2005 Dec; 8(2):3.The United Nations Population Fund (UNFPA) has launched the State of World Population 2005 report. Its central message is that, in the next decade, the world can free hundreds of millions of people from poverty, save the lives of 30 million children and two million mothers, and reverse the spread of HIV/AIDS -- all by strategic investments in various aspects of the quality of life for women and young people, particularly education, sexual and reproductive health (SRH), and economic opportunities. One of the key chapters of the report addresses the current reproductive health situation for young people, who now comprise nearly half the world's population. It describes how gender-based expectations greatly influence the experience of adolescence -- often times diminishing opportunities and increasing risks for girls. The report calls the adolescent population a "missing link" in the policy and budgets of many national governments, saying "though many countries have developed youth policies or programmes, few give youth concerns the concerted and sustained attention they deserve." (excerpt)
Bulletin of the World Health Organization. 2006 May; 84(5):338.The context for this theme collection is the publication of the report of the Commission on Intellectual Property Rights, Innovation and Public Health. The report of the Commission -- instigated by WHO's World Health Assembly in 2003 -- was an attempt to gather all the stakeholders involved to analyse the relationship between intellectual property rights, innovation and public health, with a particular focus on the question of funding and incentive mechanisms for the creation of new medicines, vaccines and diagnostic tests, to tackle diseases disproportionately affecting developing countries. In reality, generating a common analysis in the face of the divergent perspectives of stakeholders, and indeed of the Commission, presented a challenge. As in many fields -- not least in public health -- the evidence base is insufficient and contested. Even when the evidence is reasonably clear, its significance, or the appropriate conclusions to be drawn from it, may be interpreted very differently according to the viewpoint of the observer. (excerpt)
Multinational corporations and health care in the United States and Latin America: strategies, actions, and effects. [Corporaciones multinacionales y atención de la salud en Estados Unidos y América Latina: estrategias, acciones y efectos]
Journal of Health and Social Behavior. 2004; 45 Suppl:136-157.In this article we analyze the corporate dominance of health care in the United States and the dynamics that have motivated the international expansion of multinational health care corporations, especially to Latin America. We identify the strategies, actions, and effects of multinational corporations in health care delivery and public health policies. Our methods have included systematic bibliographical research and in-depth interviews in the United States, Mexico, and Brazil. Influenced by public policy makers in the United States, such organizations as the World Bank, International Monetary Fund, and World Trade Organization have advocated policies that encourage reduction and privatization of health care and public health services previously provided in the public sector. Multinational managed care organizations have entered managed care markets in several Latin American countries at the same time as they were withdrawing from managed care activities in Medicaid and Medicare within the United States. Corporate strategies have culminated in a marked expansion of corporations' access to social security and related public sector funds for the support of privatized health services. International financial institution and multinational corporations have influenced reforms that, while favorable to corporate interests, have worsened access to needed services and have strained the remaining public sector institutions. A theoretical approach to these problems emphasizes the falling rate of profit as an economic motivation of corporate actions, silent reform, and the subordination of polity to economy. Praxis to address these problems involves opposition to policies that enhance corporate interests while reducing public sector services, as well as alternative models that emphasize a strengthened public sector. (author's)
Dialectical Anthropology. 2004; 28(3-4):245-259.In the past quarter century HIV/AIDS has intensified poverty and suffering world wide, more so in underdeveloped countries and poor neighborhoods of cities within industrial nations. UNAIDS and WHO estimate that 40-60 million people are living with the disease worldwide. The poorest nations in Africa and the Caribbean in which HIV/AIDS have spread most rapidly also live under political, social and economic insecurity. For example, Haiti has experienced a brief civil war and a hurricane disaster in 2004; however, AIDS is the leading cause of death for adults, accounting for 5.9% of deaths and 20% of deaths among adult women. Many of the poorest African countries have also suffered concomitantly from civil wars and high HIV/AIDS prevalence. In the 1980s when Uganda had a civil war, this country was the epicenter of the pandemic world-wide, with an adult HIV prevalence of 30%. Liberia ended her civil war in 2003 and currently records an HIV prevalence of 8.2%. Sierra Leone also had a civil war which ended officially in 2002 with HIV/AIDS prevalence among the army of 46% and a rise in prevalence among the general population. Finally Rwanda emerged from civil war, genocide and mass dislocation in the 1990s and records 11.2% of adult prevalence. The economic crises from poor countries arose from "weak agricultural growth, a decline in industrial output, poor export production, high debt and deteriorating social indicators and institutions." Botswana with 35% prevalence and South Africa with 25% prevalence, though relatively more prosperous, continue to be weighed down by the legacy of apartheid in the form of a high migrant labor system and disruption of family life. (excerpt)
The evaluation of UNESCO Brazil's contribution to the Brazilian AIDS Programme: final report. [Evaluación del aporte de UNESCO Brasil al programa brasileño de lucha contra el SIDA: informe final]
Brasilia, Brazil, UNESCO, 2005 Jul.  p. (BR/2005/PI/H/19)This report focuses on the evaluation of the AIDS II programme, as implemented by the UNESCO office in Brazil. The AIDS epidemic has been addressed with particular vigour in Brazil, which is widely recognised as a country that has developed a distinctive and successful model of policy coordination and implementation with regard to HIV/AIDS. In addition to substantial national investment, Brazil has enjoyed co-financing from international sources especially the World Bank. In the course of three programmes - AIDS I (1994-1998), AIDS II (1998-2003) and AIDS III (2003-2007) - the World Bank committed some $365 million, matching a Brazilian Treasury contribution of $325 million. AIDS II with a total resource of $300 million is the largest of these programmes. Since the mid-1990s the UNESCO office in Brazil has grown in terms of funds managed - from some $4.5 million to $108.0 million in 2004, and in staff and activities. The overwhelming proportion of budgetary growth has come from 'extra-budgetary' resources. These are mainly Technical Cooperation agreements with the Brazilian government and with international bodies such as the World Bank. UNESCO was the 'implementing agency' along with UNODC for the AIDS II programme since its launch in 1998. In 2002, the Executive Board of UNESCO accepted a recommendation in an earlier evaluation of UNESCO programmes in Brazil2 that the AIDS II activities of UNESCO be evaluated. This evaluation was subsequently commissioned by the Brasilia office of UNESCO. (excerpt)
Boston, Massachusetts, Harvard School of Public Health, François-Xavier Bagnoud Center for Health and Human Rights, 2000. 10 p.Before human rights, there was altruism and after human rights there is altruism—the unselfish concern for the welfare of others. Altruism has been and remains an integral part of the beliefs, behaviors and practices of public health practitioners. But altruism means different things to different people. What human rights does for public health is to provide an internationally agreed upon framework for setting out the responsibilities of governments under human rights law as these relate to people’s health and welfare. Human rights as they connect to health should be understood, in the first instance, with reference to the description of health set forth in the preamble of the WHO Constitution, and repeated in many subsequent documents and currently adopted by the 191 WHO Member States: Health is a “state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” This definition has important conceptual and practical implications, as it illustrates the indivisibility and interdependence of rights as they relate to health. Rights relating to autonomy, information, education, food and nutrition, association, equality, participation and non-discrimination are integral and indivisible parts of the achievement of the highest attainable standard of health, just as the enjoyment of the right to health is inseparable from other rights, whether categorized as civil and political, economic, social or cultural. Thus, the right to the highest attainable standard of health builds on, but is by no means limited to, Article 12 of the International Covenant on Economic, Social and Cultural Rights. It transcends virtually every single other right. This paper highlights the long evolution that has brought health and human rights together in mutually reinforcing ways. It will summarize key dimensions of public health and of human rights and will suggest a manner in which these dimensions intersect in a framework of analysis and action. It will address these issues against the background of the progress being made by the World Health Organization towards defining its roles and functions from a health and human rights perspective. (excerpt)
[Report. Is sexual and reproductive health a key issue in policy proposals? The parties respond] Memoria. ¿Es la salud sexual y reproductiva un tema clave en las propuestas políticas? Los partidos responden.
[La Paz, Bolivia], Programa de Coordinacion de Salud Integral [PROCOSI], . 100 p.Sexual and reproductive health have a decisive influence on the entire population's quality of life. We felt it necessary to share this concern with the political parties that were presenting the country with all types of proposals structured around government plans. How could this issue not be dealt with? As a first step, we sought out political parties to provide them with oral and written information about this problem and motivate them to reflect on it. The second step was to invite them to present their opinions about the international progress made on sexual and reproductive health and about the agreements Bolivia has signed at worldwide conferences organized by the United Nations in Cairo (1994) and Beijing (1995). The third step was to encourage them to write up viable proposals to overcome the tragedy of high maternal mortality rates in Bolivia. These were ways to approach the issue, since covering it in all its extension is not possible. (excerpt)
Health Policy and Planning. 2005; 20(1):1-13.National governments and international agencies, including programmes like the Global Alliance for Vaccines and Immunizations and the Global Fund to Fight AIDS, Tuberculosis and Malaria, have committed to scaling up health interventions and to meeting the Millennium Development Goals (MDGs), and need information on costs of scaling up these interventions. However, there has been no systematic attempt across health interventions to determine the impact of scaling up on the costs of programmes. This paper presents a systematic review of the literature on the costs of scaling up health interventions. The objectives of this review are to identify factors affecting costs as coverage increases and to describe typical cost curves for different kinds of interventions. Thirty-seven studies were found, three containing cost data from programmes that had already been scaled up. The other studies provide either quantitative cost projections or qualitative descriptions of factors affecting costs when interventions are scaled up, and are used to determine important factors to consider when scaling up. Cost curves for the scaling up of different health interventions could not be derived with the available data. This review demonstrates that the costs of scaling up an intervention are specific to both the type of intervention and its particular setting. However, the literature indicates general principles that can guide the process: (1) calculate separate unit costs for urban and rural populations; (2) identify economies and diseconomies of scale, and separate the fixed and variable components of the costs; (3) assess availability and capacity of health human resources; and (4) include administrative costs, which can constitute a significant proportion of scale-up costs in the short run. This study is limited by the scarcity of real data reported in the public domain that address costs when scaling up health interventions. As coverage of health interventions increases in the process of meeting the MDGs and other health goals, it is recommended that costs of scaling up are reported alongside the impact on health of the scaled-up interventions. (author's)