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New York, Evaluation Office, United Nations Population Fund [UNFPA], 2016 Apr. 105 p.The purpose of the evaluation was to assess the performance of UNFPA in the field of family planning during the period covered by the Strategic Plan 2008-2013 and to provide learning to inform the implementation of the current UNFPA Family Planning Strategy Choices not chance (2012-2020). The evaluation provided an overall independent assessment of UNFPA interventions in the area of family planning and identified key lessons learned for the current and future strategies. The particular emphasis of this evaluation was on learning with a view to informing the implementation of the UNFPA family planning strategy Choices not chance 2012-2020, as well as other related interventions and programmes, such as the Global Programme to Enhance Reproductive Health Commodity Security (GPRHCS- 2013-2020). The evaluation constituted an important contribution to the mid-term review of UNFPA strategic plan 2014-2017. The evaluation features five country case study reports: Bolivia, Burkina Faso, Cambodia, Ethiopia, and Zimbabwe.
Seattle, Washington, PATH, 2013 Apr.  p.To meet the challenge of sustaining reproductive health commodity security in Eastern Europe and Central Asia, the United Nations Population Fund and PATH developed workshops to increase awareness about total market approaches and develop an action plan for the region. This report describes two regional workshops that were held in April 2013.
Road-mapping a total market approach for family planning and reproductive health commodity security. Workshop materials.
Seattle, Washington, PATH, 2013.  p.To meet the challenge of sustaining reproductive health commodity security in Eastern Europe and Central Asia, the United Nations Population Fund and PATH developed workshops to increase awareness about total market approaches and develop an action plan for the region. These workshop materials are from two regional workshops that were held in April 2013.
Challenging inequity through health systems. Final report: Knowledge Network on Health Systems. WHO Commission on the Social Determinants of Health.
[Johannesburg], South Africa, University of the Witwatersrand, Centre for Health Policy, Health Systems Knowledge Network, 2007 Jun.  p.The way that health systems are designed, financed and operated acts as a powerful determinant of health. The Health Systems Knowledge Network reviewed the evidence on different approaches to improving health equity outcomes through health systems. The focus was on innovative approaches that effectively incorporate action on the social determinants of health, and on strategies of policy development and implementation. Key themes were: Using the health sector to leverage inter-sectoral actions that address the social determinants of health; Enabling social empowerment in support of health equity; Identifying key elements of vision and health system architecture necessary to secure social protection and universal coverage; Building and maintaining national policy space for health policies that seek social justice; and Strengthening management and stewardship capacities within the health sector. The Health Systems Knowledge Network was chaired by Lucy Gilson of the Centre for Health Policy, and made up of 14 experienced policy-makers, academics and members of civil society from around the world. The Network engaged with other sections of the Commission and also commissioned a number of systematic reviews and case studies. This is the final report of the network.
Essential medicines for mothers and children: a key element of health systems. Access to medicines and public pharmaceutical policy.
Entre Nous. 2009; (68):14-15.Medicines, when used appropriately, are one of the most cost effective interventions in health care. European countries spend an important part of their health budget on medicines, from 12% on average for the EU countries to more than 30% for the Newly Independent States (NIS) countries. Whereas in EU countries the larger part of the medicines expenditures are publicly funded through taxes and/or social health insurance, in the NIS and in the south eastern European countries it is often the patients who have to pay directly for the drugs themselves. This means that many patients simply do not get the drugs they need because they cannot afford them, and also may force families to incur enormous expenses as they sell their belongings in order to pay for their drugs and their health care.
[Geneva, Switzerland], Global Fund to Fight AIDS, Tuberculosis and Malaria, 2010 Jan 12. 17 p.The AMFm is an innovative financing mechanism to expand access to affordable artemisinin-based combination therapies (ACTs) for malaria, thereby saving lives and reducing the use of inappropriate treatments. The AMFm aims to enable countries to increase the provision of affordable ACTs through the public, private not-for-profit (e.g. NGO) and private for-profit sectors. By increasing access to ACTs and displacing artemisinin monotherapies from the market, the AMFm also seeks to delay resistance to the active pharmaceutical ingredient, artemisinin.
European Journal of Contraception and Reproductive Health Care. 2008 Jun; 13(2):201-207.This paper describes an approach to maternal mortality reduction in Pakistan that uses UN emergency obstetric care (EmOC) process indicators to examine if public health care centres in Pakistan's Punjab province comply with minimum recommendations for basic and comprehensive services. In a cross sectional study in September 2003, through random sampling at area and health-facility levels from 30% of districts in Punjab province (n = 11/34 districts), all public health facilities providing EmOC were included (n = 120). Facility data were used for analysis. No district in Punjab met the minimum standards laid down by the UN for providing EmOC services. The number of facilities providing basic and comprehensive EmOC services fell far short of recommended levels. Only 4.7% of women with complications attended hospitals. Caesarean section was carried out in only 0.4% of births. The case fatality rate was hard to accurately calculate due to poor record keeping and data quality. The study may be taken asa baseline for developing and improving the standards of services in Punjab province. It is vital to upgrade existing basic EmOC facilities and to ensure that staff skills be improved, facilities be better equipped in critical areas, and record keeping be improved. Hence to reduce maternal mortality, facilities for EmOC must exist, be accessible, offer quality services, and be utilized by patients with complications. (author's)
Arlington, Virginia, John Snow [JSI], DELIVER, 2006 Nov.  p. (USAID Contract No. HRN-C-00-00-00010-00)In light of the phaseout of donor funds for family planning in Latin America and the Caribbean, Paraguay will be facing increasing responsibility to finance and procure contraceptive commodities in the near future. The Government of Paraguay will need to look at regional and international procurement opportunities to ensure that contraceptive security is not compromised during this transition period. This report presents findings from a legal and regulatory analysis and pricing study of different procurement options to identify efficient, economical, high quality and timely distribution of contraceptives. A summary of the current country situation, procurement practices, laws, policies, and regulations is presented along with a comparison of regional contraceptive prices. Options and recommendations are presented for next steps. (author's)
Arlington, Virginia, John Snow [JSI], DELIVER, 2006 Nov.  p. (USAID Contract No. HRN-C-00-00-00010-00)In light of the phaseout of donor funds in Latin America and the Caribbean, Nicaragua will be facing increasing responsibility to finance and procure contraceptive commodities in the near future. The Government of Nicaragua needs to look at regional and international procurement opportunities to ensure that contraceptive security is not compromised during this transition period. This report presents findings from a legal and regulatory analysis and pricing study of various procurement options to identify efficient, economical, and timely distribution of high-quality contraceptives. A summary of the current country situation, procurement practices, laws, policies, and regulations is presented along with a comparison of regional contraceptive prices. Options and recommendations are presented for next steps. (author's)
Arlington, Virginia, John Snow [JSI], DELIVER, 2006 Nov.  p. (USAID Contract No. HRN-C-00-00-00010-00)In light of the phaseout of donor funds in Latin America and the Caribbean, the Dominican Republic will be facing increasing responsibility to finance and procure contraceptive commodities in the near future. The government of the Dominican Republic needs to look at regional and international procurement opportunities to ensure that contraceptive security is not compromised during this transition period. This report presents findings from a legal and regulatory analysis and pricing study of various procurement options to identify efficient, economical, and timely distribution of high-quality contraceptives. A summary of the current country situation, procurement practices, laws, policies, and regulations is presented along with a comparison of regional contraceptive prices. Options and recommendations are presented for next steps. (author's)
Journal of the Indian Medical Association. 2007 Apr; 105(4):198, 212.Tuberculosis has been declared to be a global emergency and the HIV/AIDS is fuelling the epidemic. To contain the disease for its re-emergence a massive funding was earmarked. Widespread implementation of the DOTS strategy specially in countries of high TB burden is a major progress in global TB control. As a sizeable section of TB patients contact a private health provider, so the policy makers of health envisaged the idea for Public-Private Partnership mix model to contain the disease and hence the role of IMA with its two lacs members has definite role to play to stop the menace. The Stop TB strategy is designed to achieve the targets set for the period 2006-2015. Members of IMA have got a life time chance to prove to the people and to the power that they are not lagging behind in providing a service to the nation and there lies the strength of the IMA. (author's)
Public-private mix for TB care and control. Focus on Africa. Report of the fourth meeting of the Subgroup on Public-Private Mix for TB Care and Control, 12-14 September 2006, Nairobi, Kenya.
Geneva, Switzerland, World Health Organization [WHO], Stop TB Department, 2007. 27 p. (WHO/HTM/TB/2007.378)The Subgroup on Public-Private Mix for DOTS Expansion (PPM Subgroup) was established by the global Stop TB Partnership's DOTS Expansion Working Group (DEWG) to help promote and facilitate active engagement of all relevant public and private health care providers in TB control. The members of the Subgroup include representatives from the private sector, academia, country TB programme managers, policy-makers, field experts working on the issue, international technical partners and donor agencies. At the first meeting of the Subgroup in November 2002, generic regional and national Public-Private Mix (PPM) strategies were developed and endorsed. The Subgroup's second meeting, which was held at the WHO Regional Office for South-East Asia in New Delhi in February 2004, reviewed the growing evidence base emerging from numerous PPM initiatives. This meeting also broadened the scope of PPM to include the involvement of public sector providers not yet linked to national tuberculosis programmes (NTPs). Consequently, PPM has since stood for the engagement of all public and private health care providers through public-private, public-public and private-private collaboration in TB control. The third meeting of the Subgroup, held in Manila in April 2005, identified barriers and enablers for scaling up and sustaining PPM, and discussed how to mainstream PPM into regular TB control planning and implementation. The Subgroup's current fourth meeting in Nairobi, Kenya, in September 2006 had PPM for TB control in Africa as the main focus. The problems related to the HIV epidemic, human resources for health and health sector reforms pose special challenges to countries in Africa. The meeting examined how successful PPM approaches within Africa could be scaled up and how approaches applied in other regions could be adapted to African settings. Based on a global overview, the African experience in diverse country settings and field visits to examine working PPM models and after a great deal of deliberations and discussions, the Subgroup made recommendations which are presented in Section 6 of the report. A large part of the funding for the meeting was provided by USAID's Tuberculosis Control Assistance Program (TB CAP). (excerpt)
Access to treatment in the private-sector workplace: the provision of antiretroviral therapy by three companies in South Africa.
Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2005 Jul. 47 p. (UNAIDS Best Practice Collection; UNAIDS/05.11E)The availability of antiretroviral therapy from 1996 onwards has made a huge impact on the lives of those people living with HIV who can afford the drugs. But most of the beneficiaries of the new drugs live in the world's high-income countries. For many of them, AIDS has become a manageable chronic condition rather than a death sentence. Affluent countries have seen a 70% decline in AIDS-related deaths since the introduction of antiretroviral therapy. In countries in which antiretroviral drugs are provided on a large scale (in Brazil, for example), the impact is remarkable. The number of hospital patients with AIDS is greatly reduced, people living with AIDS return to their families and jobs, and AIDS-related morbidity and mortality fall dramatically. However, for the huge majority of people living with HIV in low- and middle-income countries, it is a different story. Neither they nor their countries' health-care services can afford to annually pay the huge amounts of money that the drugs cost, even taking into account recent reductions in drug prices. Cost has not been the only barrier to wide-scale provision of antiretroviral therapy in low- and middle-income countries. Health experts have expressed concerns about providing drugs to large numbers of people in settings where health-care services do not even offer adequate basic care, let alone the support and monitoring needed for antiretroviral therapy. The slow progress in antiretroviral provision has meant that although five to six million people need antiretroviral therapy in low- and middle-income countries, only about 700 000 had access to it by the end of 2004. In sub-Saharan Africa, more than four million people need treatment, but only 310 000 had access by the end of 2004. (excerpt)
Building effective public-private partnerships: experiences and lessons from the African Comprehensive HIV / AIDS Partnerships (ACHAP).
Social Science and Medicine. 2006 Jul; 63(2):397-408.This paper examines the processes for building highly collaborative public--private partnerships for public health, with a focus on the efforts to manage the complex relationships that underlie these partnerships. These processes are analyzed for the African Comprehensive HIV/AIDS Partnerships (ACHAP), a 5-year partnership (2001--2005) between the government of Botswana, Merck & Co., Inc. (and its company foundation), and the Bill & Melinda Gates Foundation. ACHAP is a highly collaborative initiative. The ACHAP office in Botswana engages intensively (on a daily basis) with the government of Botswana (an ACHAP partner and ACHAP's main grantee) to support HIV/AIDS control in that country, which had an adult prevalence of 38.5% HIV infection in 2000 when ACHAP was being established. The paper discusses the development of ACHAP in four stages: the creation of ACHAP, the first year, the second and third years, and the fourth year. Based on ACHAP's experiences over these four years, the paper identifies five lessons for managing relationships in highly collaborative public--private partnerships for public health. (author's)
Helping public sector health systems innovate: the strategic approach to strengthening reproductive health policies and programs.
American Journal of Public Health. 2006 Mar; 96(3):435-440.Public sector health systems that provide services to poor and marginalized populations in developing countries face great challenges. Change associated with health sector reform and structural adjustment often leaves these already-strained institutions with fewer resources and insufficient capacity to relieve health burdens. The Strategic Approach to Strengthening Reproductive Health Policies and Programs is a methodological innovation developed by the World Health Organization and its partners to help countries identify and prioritize their reproductive health service needs, test appropriate interventions, and scale up successful innovations to a subnational or national level. The participatory, interdisciplinary, and country-owned process can set in motion much-needed change. We describe key features of this approach, provide illustrations from country experiences, and use insights from the diffusion of innovation literature to explain the approach's dissemination and sustainability. (author's)
Structural adjustment in sub-Saharan Africa. Report on a series of five senior policy seminars held in Africa, 1987-88.
Washington, D.C., World Bank, 1989.  p. (EDI Policy Seminar Report No. 18)In June 1986, the National Economic Management Division of the World Bank's Economic Development Institute (EDI) designed a series of senior policy seminars on structural adjustment for Sub-Saharan Africa. The exercise led to three seminars in 1987: Lusaka I, Lusaka 11, and Abidjan I, and, after redesign, two more in 1988: Victoria Falls and Abidjan 11. Seminar participants were invited in teams typically composed of ministers, governors, permanent secretaries, senior advisors, and a significant number of senior technical staff of central banks, the core ministries of finance and planning, and spending ministries such as agriculture and industry. Twenty seven countries participated in the seminars. Of these, six participated in two separate seminars (see annex A). This report is a synthesized record of the five seminars and is likely to be of interest to all those interested in the reform process in Sub-Saharan Africa, namely, the seminar participants, other similarly placed policymakers, advisors to these policymakers, executives of the public and private sectors, staff of academic institutions, and the staff of international organizations such as the World Bank (the Bank) and the International Monetary Fund (the Fund) involved in studying the political economy of structural adjustment. (excerpt)
In: Global appeal, 2003. Strategies and programmes, [compiled by] United Nations High Commissioner for Refugees [UNHCR]. Geneva, Switzerland, UNHCR, 2003. 36-51.Ensuring equal rights and access by refugee women to all aspects of protection and assistance provided by UNHCR, is central to the Office’s refugee protection mandate. This policy commitment is grounded in international agreements and standards, such as the Beijing Declaration and Platform for Action, and the Convention on the Elimination of all Forms of Discrimination against Women (CEDAW). UNHCR employs various strategies to make good this commitment, including: elaborating policy guidelines and training materials; providing technical advice and support to operational units; pursuing consultations and partnerships with refugees, particularly women; piloting innovative approaches to empower refugee women; and monitoring and evaluating field-related activities. During the global consultations with refugee women in 2001, the High Commissioner made five commitments: the promotion of women’s equal participation in leadership and decision-making; equal participation in the distribution of food and non-food items; individual registration and documentation of refugee women; support for integrated sexual and gender-based violence programmes at national levels; and the inclusion of sanitary materials within standard assistance packages provided to refugees. These commitments continue to be implemented in practical and measurable ways. (excerpt)
The role and influence of stakeholders and donors on reproductive health services in Turkey: a critical review.
Reproductive Health Matters. 2004; 12(24):116-127.Since 1965, Turkey has followed an anti-natalist population policy and made significant progress in improving sexual and reproductive health. This paper presents a critical review of the national reproductive health policies and programmes of Turkey and discusses the influence of national and international stakeholders and donors on policy and implementation. While government health services have played the primary role in meeting sexual and reproductive health needs, international donor agencies and national non-governmental and other civil society organisations, especially universities, have played an important complementary role. Major donor agencies have supported many beneficial programmes to improve reproductive health in Turkey, but their agendas have sometimes not been compatible with national objectives and goals, which has caused frustration. The main conclusion of this review is that countries with clear and strong reproductive health policies can better direct the implementation of international agreements as well as get the most benefit from the support of international donors. (author's)
Investing in a comprehensive health sector response to HIV / AIDS. Scaling up treatment and accelerating prevention. WHO HIV / AIDS plan, January 2004 - December 2005.
Geneva, Switzerland, WHO, 2004. 72 p.This document discusses the context for the work being undertaken in WHO’s HIV/AIDS programme. It analyses the epidemiological situation and includes the most recent estimates of antiretroviral coverage, the global strategic framework and current challenges to translating this into results at the country level (Section 1 – Background). Section 2 describes the comparative advantages offered by WHO, the functional areas of activity within the HIV/AIDS area of work for 2004–2005 and the specific focus of the programme on scaling up antiretroviral therapy and accelerating HIV prevention. Section 3 describes how WHO is structured and how resources and capacity are being reoriented to support country-level action. Section 4 illustrates how WHO works within the United Nations system and with other partners. Section 5 outlines the resources required in 2004–2005 for WHO to accomplish its stated contribution to HIV/AIDS. Section 6 describes the mechanisms for technical and managerial oversight of the HIV/AIDS programme. The WHO HIV/AIDS Plan is not a detailed work plan. Rather, it provides an overall framework to guide the departments responsible for HIV/AIDS in preparing such work plans at the country, regional and headquarters levels of WHO. These work plans are now being developed and will define the specific tasks and activities required to bring the WHO HIV/AIDS Plan to fruition, together with timelines and resource requirements. Joint planning sessions between headquarters, regional and country offices integrate the work of the three levels to ensure that all priority needs are addressed and that gaps in resources are identified. (excerpt)
The role of the health sector in supporting adolescent health and development. Materials prepared for the technical briefing at the World Health Assembly, 22 May 2003.
Geneva, Switzerland, World Health Organization [WHO], 2003. 15 p.I am very pleased to be here, and to be part of the discussion on Young Peoples Health at the World Health Assembly, for two reasons: because of the work we have been doing in adolescent health over the past years together with the Member States of the European Region of WHO, the work in cooperation with other UN agencies, especially UNICEF, UNFPA, and UNAIDS on adolescent health and development. Secondly, because Youth is a priority area of work of German Development Cooperation, and of the German Agency for Technical Cooperation, where I am working presently. Indeed, we have devoted this years GTZ´s open house day on development cooperation to youth I would also like to take this opportunity to remember the work of the late Dr. Herbert Friedman, former Chief of Adolescent Health in WHO, whose vision of the importance of working for and with young people has inspired many of the national plans and initiatives which we will hear about today. In many countries of the world, young people form the majority of populations, and yet their needs are being insufficiently met through existing health and social services. The health of young people was long denied the public, and public health attention it deserves. Adolescence is a driving force of personal, but also social development, as young people gradually discover, and question and challenge the adult world they are growing into. (excerpt)
Arlington, Virginia, John Snow [JSI], Family Planning Logistics Management [FPLM], 2000. x, 67 p. (USAID Contract No. CCP-C-00-95-00028-00)This report documents the status of technical assistance provided by the USAID-funded Family Planning Logistics Management project to the Bangladesh Family Planning Program in developing a countrywide contraceptive logistics system. A study conducted in November 1999 to evaluate the impact of technical assistance on logistics management and contraceptive security is detailed. The report concludes with findings from the study, lessons learned, and recommendations to continue improvements in the system. (author's)
Micro-finance in rural communities in Southern Africa. Country and pilot site case studies, policy issues and recommendations.
Pretoria, South Africa, Human Sciences Research Council, 2002. , 170 p.While micro-finance in its various forms has helped to make loan capital more accessible to low-income rural communities, much remains to be done to increase its outreach, impact and sustainability. The essential objective of this study is to make well-researched recommendations for IRDP policy and strategy to enable the micro-finance agents that it will shortly be appointing to maximize improvements in these key indicators in the three pilot sites. Chapter 1 outlines the institutional context and terms of reference of the report and briefly discusses its timeframe, methodology, value and limitations. Chapters 2 and 3 depict, on the one hand, the demand for financial services in the three pilot sites and, on the other, access to micro-finance in the respective communities. In Chapter 4 an account is given of the essential nature and capabilities of microfinance, of recent developments in this regard, of fundamental lessons from international experience and of best practices in a rural context. Chapter 5 identifies the key sets of policy issues facing, in the first instance, public policy makers seeking to promote micro-finance development and, in the second, donors/investors/wholesalers seeking to support individual micro-finance retailers. It then applies the findings of Chapter 4 to the three on-the-ground pictures sketched out in Chapters 2 and 3 to arrive at some initial and very tentative recommendations for policy for the IRDP in the respective pilot sites. (excerpt)
BMJ. British Medical Journal. 2003 Jul 5; 327:3-4.One promising strategy is to market sanitation and handwashing as if they were consumer products like cars or shampoo. Consumers see the building of a toilet as a home improvement not as a health intervention. Equally they use soap to make hands look, feel, and smell good, not to prevent sickness. Public money could be spent on marketing hygiene and toilets, thus generating demand that can then be met by the private sector. The private sector also knows how to generate behaviour change through marketing. If consumer demand for hygiene and toilets can be stimulated with the help of the private sector, public funds can be liberated to support public infrastructure and to help the very poorest who cannot afford to adopt new technologies. This approach is being tested in six countries, where public-private partnerships between soap companies, governments, and agencies such as theWorld Bank aim to increase rates of handwashing with soap massively (www.globalhandwashing.org). (excerpt)
Cambridge, Massachusetts, Harvard Center for Population and Development Studies, 2002 Apr. ix, 205 p. (Harvard Series on Population and International Health)This book presents the results of the workshop. The essays in this volume offer some fresh perspectives on partnerships, probe some troubling questions, and provide empirical evidence of both benefits and challenges of public-private partnerships. The participants in the meeting also achieved some progress in creating a shared vocabulary, or at least shared understanding, on points of contention, suggesting that dialogue among partisans in public health can help move debates about critical issues forward. (excerpt)
BMJ. British Medical Journal. 2002 Dec 7; 325(7376):1320.Global targets for the control of tuberculosis will not be met unless the public sector can engage the growing army of private doctors who now treat patients with tuberculosis and improve these doctors' management of the disease. This is one key conclusion of a working group at the World Health Organization (WHO). The group is calling for increased resources and urgent action to build partnerships between private and public sectors in countries where the tuberculosis burden is high, including India, Indonesia, and the Philippines. (excerpt)