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This report summarizes the findings of the Health Financing Progress Matrix assessment for Zambia. Recognizing the remarkable progress towards UHC made by the country over the past twenty years, the report also highlights weaknesses in the current health financing system and, extending from this, those priority issues to be addressed in order to further accelerate Zambia’s progress towards universal health coverage (UHC). Specifically, the report notes the importance of sustaining levels of public funding for health, progressively reducing reliance on external funding, and reinforcing the provision of free services in primary care facilities. Further recommendations include the need to accelerate the shift from passive to strategic purchasing, and institutionalizing shifts in the public financial management system to ensure that adequate operational funds reach frontline service providers in a timely fashion. Finally, the duplication in benefits across the budget-funded EPHS, the National Health Insurance Scheme, and some services provided through vertical disease programmes need to be addressed, for example through the establishment of a unified benefits framework. The latest information on Zambia’s performance in terms of UHC and key health expenditure indicators are also presented. This report is intended both to inform current health financing policy, and to provide a baseline for the future monitoring of Zambia’s progress in developing and implementing UHC-oriented health financing reforms.
In 2011 the World Bank—with funding from the Bill and Melinda Gates Foundation—launched the Global Findex database, the world's most comprehensive data set on how adults save, borrow, make payments, and manage risk. Drawing on survey data collected in collaboration with Gallup, Inc., the Global Findex database covers more than 140 economies around the world. The initial survey round was followed by a second one in 2014 and by a third in 2017. Compiled using nationally representative surveys of more than 150,000 adults age 15 and above in over 140 economies, The Global Findex Database 2017: Measuring Financial Inclusion and the Fintech Revolution includes updated indicators on access to and use of formal and informal financial services. It has additional data on the use of financial technology (or fintech), including the use of mobile phones and the Internet to conduct financial transactions. The data reveal opportunities to expand access to financial services among people who do not have an account—the unbanked—as well as to promote greater use of digital financial services among those who do have an account. The Global Findex database has become a mainstay of global efforts to promote financial inclusion. In addition to being widely cited by scholars and development practitioners, Global Findex data are used to track progress toward the World Bank goal of Universal Financial Access by 2020 and the United Nations Sustainable Development Goals. The database, the full text of the report, and the underlying country-level data for all figures—along with the questionnaire, the survey methodology, and other relevant materials—are available at www.worldbank.org/globalfindex.
The UHC Partnership (UHC-P) is a collaborative agreement between WHO, several donors (namely: the EU, the Grand Duchy of Luxembourg, Irish Aid, the Government of Japan, the French Ministry for Europe and Foreign Affairs, Germany, Canada, Belgium and the UK Department for International Development) and a number of partner countries (currently, 125 partner countries across all six WHO regions) to support policy dialogue on national health policies, strategies, and plans (NHPSPs) and UHC -and it is part of the WHO Special Programme on Primary Health Care (SP-PHC). Its overall objective being to improve health sector results in concerned countries, it aims at building country capacities (and strengthening country processes) for the development, negotiation, implementation, monitoring and evaluation of robust and comprehensive NHPSPs with a view on promoting UHC; health in all policies; and people-centered primary care -as indeed, investments in quality primary health care (PHC) will be the cornerstone for achieving UHC around the world. The purpose of this publication is to document accomplishments of the UHC-P in 2022 for the 125 partner countries. The annual UHC-P report serves as a single report to all nine donors supporting the Partnership. It will provide a synthesis of activities and results achieved in all the participating countries; present a range of country examples related to the major areas of work; and also elaborate on how the UHC-P achieved sustainable buy-in of partners and stakeholders at the country level in the different countries concerned.
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.
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.
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.
This report discusses several different approaches that support reforming health care services in developing countries. For some time now, health care services have been supported by government funds. As demands for improving health care services continue to increase additional demands will be placed on governments to respond. This, however, will not be easy. Slow economic growth and record budget deficits in the 1980's have forced reductions in public spending. Alternative approaches to finance health care services are needed. Such possible changes could involve: decentralization of federal government involvement; the promotion of nongovernment involvement; the imposition of user fees; and, establishing health insurance. Finally, the role of the Bank in pursuing new financing strategies is discussed.
This edition of the OECD Sovereign Borrowing Outlook reviews developments in response to the COVID-19 pandemic for government borrowing needs, funding conditions and funding strategies in the OECD area.
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.