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This document outlines the background to and design of the Health Financing Progress Matrix (HFPM), WHO’s standardized qualitative approach to assessing country health financing systems. Primarily qualitative in nature, but drawing on extensive quantitative indicators, the HFPM assesses a country’s health financing institutions, processes, policies and their implementation, against good practice in the context of universal health coverage (UHC). Benchmarks are defined in terms of nineteen desirable attributes, which crystallize evidence about what works in health financing in order to make progress to UHC. The paper also details a number of processes which govern the implementation of the HFPM in countries, to ensure the results are objective and credible. While health financing is only one of the core functions of a health system, it significantly influences both the extent to which the population can access health services, as well as the extent to which they face financial hardship in the process. Through a forward-looking design, the HFPM not only assesses the current situation in a country, but also makes clear recommendations of priority directions for policy and implementation, both accelerating progress towards UHC, and helping to build resilience across the health systems.
This overview of health financing tools, policies and trends--with a particular focus on challenges facing developing countries--provides the basis for effective policy-making. Analyzing the current global environment, the book discusses health financing goals in the context of both the underlying health, demographic, social, economic, political and demographic analytics as well as the institutional realities faced by developing countries, and assesses policy options in the context of global evidence, the international aid architecture, cross-sectoral interactions, and countries' macroeconomic frameworks and overall development plans.
This document provides detailed advice in support of implementation of version 2.0 of the Health Financing Progress Matrix (HFPM) released in December 2020, detailed in Assessing country health financing systems: the health financing progress matrix. Geneva: World Health Organization; 2020. The HFPM is WHO’s standardized qualitative approach to assessing country health financing systems, and comprises two stages. Stage 1 provides a descriptive landscape of the different coverage schemes and programmes in the health system, including how the health budget is organized. Stage 2 comprises thirty-three questions which look in detail at the way health financing institutions and policies are organized, and how they are implemented. For each question the guide discusses why it is important to ask, and what progress looks like, together with country illustrations. Thoughts on information sources and quantitative indicators which can support the assessment are also provided.
Increased global demand for land posits the need for well-designed country-level land policies to protect long-held rights, facilitate land access and address any constraints that land policy may pose for broader growth. While the implementation of land reforms can be a lengthy process, the need to swiftly identify key land policy challenges and devise responses that allow the monitoring of progress, in a way that minimizes conflicts and supports broader development goals, is clear. The Land Governance Assessment Framework (LGAF) makes a substantive contribution to the land sector by providing a quick and innovative tool to monitor land governance at the country level. The LGAF offers a comprehensive diagnostic tool that covers five main areas for policy intervention: Legal and institutional framework; Land use planning, management and taxation; Management of public land; Public provision of land information; and Dispute resolution and conflict management. The LGAF assesses these areas through a set of detailed indicators that are rated on a scale of pre-coded statements (from lack of good governance to good practice). While land governance can be highly technical in nature and tends to be addressed in a partial and sporadic manner, the LGAF posits a tool for a comprehensive assessment, taking into account the broad range of issues that land governance encompasses, while enabling those unfamiliar with land to grasp its full complexity. The LGAF will make it possible for policymakers to make sense of the technical levels of the land sector, benchmark governance, identify areas that require further attention and monitor progress. It is intended to assist countries in prioritizing reforms in the land sector by providing a holistic diagnostic review that can inform policy dialogue in a clear and targeted manner. In addition to presenting the LGAF tool, this book includes detailed case studies on its implementation in five selected countries: Peru, the Kyrgyz Republic, Ethiopia, Indonesia and Tanzania.
Since independence, Bangladesh has achieved impressive economic growth and social development, making steady progress in reducing poverty and significant improvements in living standards. The COVID-19 pandemic interrupted this long period of robust economic performance, deepening some earlier vulnerabilities. Stagnating job growth, rising inequality, and slowing poverty reduction remain challenges. Revenues are low, and financial sector vulnerabilities continue to be high. Substantial productive investment in infrastructure, human capital, and climate resilience is needed to achieve the authorities’ aspiration to reach the upper-middle income status in 2031.
Social justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death. We watch in wonder as life expectancy and good health continue to increase in parts of the world and in alarm as they fail to improve in others.
Interest in implementation research is growing, largely in recognition of the contribution it can make to maximizing the beneficial impact of health interventions. As a relatively new and, until recently, rather neglected field within the health sector, implementation research is something of an unknown quantity for many. There is therefore a need for greater clarity about what exactly implementation research is, and what it can offer. This Guide is designed to provide that clarity. Intended to support those conducting implementation research, those with responsibility for implementing programs, and those who have an interest in both, the Guide provides an introduction to basic implementation research concepts and language, briefly outlines what it involves, and describes the many opportunities that it presents. The main aim of the Guide is to boost implementation research capacity as well as demand for implementation research that is aligned with need, and that is of particular relevance to health systems in low- and middle-income countries (LMICs). Research on implementation requires the engagement of diverse stakeholders and multiple disciplines in order to address the complex implementation challenges they face. For this reason, the Guide is intended for a variety of actors who contribute to and/or are impacted by implementation research. This includes the decision-makers responsible for designing policies and managing programs whose decisions shape implementation and scale-up processes, as well as the practitioners and front-line workers who ultimately implement these decisions along with researchers from different disciplines who bring expertise in systematically collecting and analyzing information to inform implementation questions. The opening chapters (1-4) make the case for why implementation research is important to decision-making. They offer a workable definition of implementation research and illustrate the relevance of research to problems that are often considered to be simply administrative and provide examples of how such problems can be framed as implementation research questions. The early chapters also deal with the conduct of implementation research, emphasizing the importance of collaboration and discussing the role of implementers in the planning and designing of studies, the collection and analysis of data, as well as in the dissemination and use of results. The second half of the Guide (5-7) detail the various methods and study designs that can be used to carry out implementation research, and, using examples, illustrates the application of quantitative, qualitative, and mixed-method designs to answer complex questions related to implementation and scale-up. It offers guidance on conceptualizing an implementation research study from the identification of the problem, development of research questions, identification of implementation outcomes and variables, as well as the selection of the study design and methods while also addressing important questions of rigor.
We review Greek public sector healthcare policies and health-related outcomes since 2010.We find that excess spending was successfully curtailed, elements of the institutional framework were modernized, and health outcomes have been relatively favorable. However, especially prior to Covid-19, public healthcare spending had been compressed to potentially unsustainable levels, with widening inequalities and large unmet needs, especially among the poor. Higher public spending and advancing structural healthcare reforms are needed to improve the efficiency and equity of the Greek healthcare system, including strengthening primary healthcare, reducing out-of-pocket payments, and eliminating remaining insurance gaps.
Between 2011 and 2019, WHO has developed and issued evidence-based policy recommendations on the treatment and care of patients with DR-TB. These policy recommendations have been presented in several WHO documents and their associated annexes, including the WHO Consolidated Guidelines on Drug Resistant Tuberculosis Treatment, issued by WHO in March 2019. The policy recommendations in each of these guidelines have been developed by WHO-convened Guideline Development Groups, using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to summarize the evidence, and formulate policy recommendations and accompanying remarks. The present WHO Consolidated Guidelines on Tuberculosis, Module 4: Treatment - Drug-Resistant Tuberculosis Treatment includes a comprehensive set of WHO recommendations for the treatment and care of DR-TB. The document includes two new recommendations, one on the composition of shorter regimens and one on the use of the BPaL regimen (i.e. bedaquiline, pretomanid and linezolid). In addition, the consolidated guidelines include existing recommendations on treatment regimens for isoniazid-resistant TB and MDR/RR-TB, including longer regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), the use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care. The guidelines are to be used primarily in national TB programmes, or their equivalents in Ministries of Health, and for other policy-makers and technical organizations working on TB and infectious diseases in public and private sectors and in the community.