Other Health Study

415 items available

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https://hdl.handle.net/10986/2203

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Budget Execution in Health: From Bottlenecks to Solutions
(World Health Organization and the World Bank, 2025-03-11) World Health Organization; World Bank
This report builds on a joint WHO-World Bank initiative on budget execution challenges (described in more detail in Appendix 1). Following the introduction, section 2 provides an overview of core concepts from both a public financial management perspective and a health financing perspective and discusses how budget execution challenges can differ in countries with a separate purchasing agency, varying degrees of decentralization and significant donor funding. The trends and patterns in health budget execution data are analyzed and discussed in section 3. The analytical approach is detailed in Appendix 2. Section 4 identifies challenges that hinder good budget execution in health. These are drawn from an extensive literature review and a set of case studies. A summary of the case studies is provided in Appendix 3. Policy responses to these challenges are offered in section 5. This section lays out a pragmatic approach that Ministries of Finance, Ministries of Health and local governments can take to address six of the most frequently encountered budget execution challenges and points to examples from cases studies. Section 6 offers an engagement approach to address budget execution challenges. A four step diagnostic-to-solution model is proposed that guides an analyst through the process of identifying the right questions, data, and policy options in a structured manner. Section 7 concludes with a call to action for countries to embrace a more purposeful and collaborative budget implementation approach that involves finance, health and local government stakeholders. The compiled dataset used for the analysis is being released jointly with this report to support complementary analytical efforts.
Transforming Health Care in Lesotho: Using Digital Health to Overcome Health System Challenges
(Washington, DC: World Bank, 2025-01-21) World Bank
Healthcare access and service delivery quality have been a persistent challenge in Lesotho. The COVID-19 pandemic has added new challenges and opportunities for change. Among those changes is the need to include digital health solutions and think about how new digital health interventions can enhance efficiency and transform the way primary healthcare is being provided or delivered in the country. This report, prepared by the World Bank for Lesotho’s Ministry of Health, documents the outcome of an assessment of Lesotho’s digital health system using a unique digital health assessment toolkit produced by the World Bank. The agreed objectives of the assessment were to 1) clarify the current digital health landscape in Lesotho, 2) develop a maturity score for Lesotho’s digital health system, 3) define the strengths, weaknesses, opportunities, and threats (SWOT) facing digital health in Lesotho and 4) Using the results of the assessment, provide recommendations and a phased roadmap of action to define the key strategic actions to move Lesotho’s digital health ecosystem to the next phase of its evolution. Based on the assessment results, 16 strategic recommendations have been made on foundational, functional, and frontier investments to advance the digital health agenda and improve service delivery. The prioritization of the actions has been based on this set of criteria: the most urgent to support PHC transformation, the incomplete actions from the current draft of the e-Health Strategy (2019-2023), and those with the most important long-term impact. This report is a call to action to upgrade the current eHealth strategy to a comprehensive digital health strategy with priority interventions, a costed implementation plan, and provisions for future impact assessment geared toward delivering better health in a digital world.
Assessment OF UHC Performance Monitoring System and UHC Budget and Expenditure Analysis in Pakistan
(Washington, DC: World Bank, 2025-01-08) World Bank
In 2016, Pakistan adopted the Sustainable Development Goals (SDGs) into its national development agenda as part of its commitment to the 2030 Agenda for Universal Health Coverage (UHC). In 2018, the Government of Pakistan designed and approved a National SDGs Framework to prioritize and localize SDGs, which included an accelerated path toward UHC. To measure the global advancement toward UHC, the World Bank and the World Health Organization (WHO) have regularly issued reports concerning how countries were progressing in achieving their goals. However, there is a fundamental challenge in reporting because UHC means different things to different countries, both at the national and sub-national levels. To address this challenge in Pakistan, the Ministry of National Health Services, Regulation and Coordination (MONHSRC) released a report that derives a public health system output referred to as the UHC Index. It uniformly measures the UHC at the subnational levels. The Index is derived from the 16 clusters1 identified by the WHO to monitor the UHC. The UHC analysis brought to light the need for interventions to improve the District Health Information System (DHIS) data quality, as well as steps to improve the Financial Accounting and Budgeting System (FABS) health budget coding. The DHIS data does not provide information about noncommunicable diseases (NCDs). Thus, it needs to be supplemented with other regularly reported information at the district level to monitor the NCD cluster. In addition, the DHIS internal verification mechanisms should be reinstituted, and further effort will be required to ensure data reliability. The reported wide variation in the Expanded Program on Immunization (EPI) indicators is an example of the lack of standardization in the system that should be addressed. For budgeting and accounting, the Government of Pakistan has a unified Chart of Accounts (CoA). It is implemented at all tiers of government. For a country of its size and diversification, this represents a major feat. Accounting data is reliable, and the financial reports generated are credible. However, the use of the CoA in the health sector is not consistent across provinces, which creates difficulties in producing an aggregate view of sector allocations and spending from the FABS.
Internal Control Assessment at the Primary Health Care Centers in Pakistan: Options to Improve the Flow of Funds for Front-line Health Workers
(Washington, DC: World Bank, 2025-01-08) World Bank
This report reflects on the findings from an internal control assessment of health service delivery units for primary health care, as well as a subsequent options analysis. Together, they show significant opportunities for improved systemic efficiency, as low-value, frequent transactions (that are primarily non-salary expenditures including fuel and travel allowances) comprise over fifty percent of total health expenditure transactions in Pakistan. However, they make up only two three percent of the total health budget. Although minor in size and value, these multiple transactions go through the complete approval cycle, causing delayed payments and resulting in an increased administrative burden, with a considerable negative impact on service delivery.
Health System Technical Support to Government of Ghana: Assessing Networks of Practice Through Patient Pathway and Network Analytics Recommendation Design Report
(Washington, DC: World Bank, 2025-01-03) World Bank
This report is focusing on the implementation of Networks of Practice (NoP) to improve primary healthcare delivery. The report highlights the need for a comprehensive mapping approach to configure new NoPs, prioritizing the upgrading of network hubs to reorient patient pathways and decongest hospitals. It emphasizes investing in human resources at primary care facilities to improve patient-provider interactions and strengthen the quality of care, especially in network hubs. The report also recommends improving NoP maintenance efforts, building capacity on patient referrals, and promoting health equity through increased awareness, community engagement, and financial protection. Additionally, it suggests designing effective urban NoPs to address the unique challenges of urban healthcare delivery. The report concludes that these recommendations aim to enhance healthcare delivery and outcomes through a successful NoP program, ultimately contributing to a more resilient health system in Ghana
Health System Technical Support to Government of Ghana: Patient Pathway Analysis and Summative Network Analysis - Consolidated Findings Report
(Washington, DC: World Bank, 2025-01-02) World Bank
This report is a comprehensive analysis of Ghana's health system, focusing on the Patient Pathway Analysis (PPA) and Summative Network Analysis (SNA). It highlights the implementation of Networks of Practice (NoP) to improve primary healthcare delivery. The report covers the methodology, findings, and recommendations for enhancing healthcare access and quality. Key findings include high utilization of hospitals for maternal and neonatal health (MNH) and hypertension (HTN) care, with a preference for quality care and proximity. The NoP districts showed better resource sharing, collaboration, and community engagement compared to non-NoP districts. The report suggests strategies for optimal NoP performance, including advocacy, patient-centered mapping, routine system strengthening, and continuous learning.
Reduction of Mental Health Related Stigma and Discrimination: Global Overview
(Washington, DC: World Bank, 2024-11-25) World Bank
Stigma and discrimination contravene basic human rights and have detrimental effects on people with mental health conditions by exacerbating marginalization and social exclusion, including by reducing access to mental and physical health care and diminishing educational and employment opportunities. The stigma and discrimination surrounding mental health have negative consequences for social exclusion in relation to education, the workplace, and the community, as well as for marital prospects, loss of property, inheritance, or rights to vote, and poor quality health care for mental and physical health conditions. Stigma powerfully and adversely affects individuals, families, communities, and society, and exists across all countries and cultures. A recent global survey of people with mental health conditions across 45 countries found that 80 percent agreed that stigma and discrimination can be worse that the impact of the mental health condition itself. The overall objective of this policy note, prepared jointly by the World Bank Group and Korean National Center for Mental Health, is to summarize global evidence for effective interventions to reduce mental health-related stigma and discrimination. The first section of this report defines stigma and discrimination, describes the adverse impact on the lives of people with mental health conditions, and summarizes results of a narrative literature review of the evidence base for interventions addressing mental illness-related stigma and discrimination. This report involved a synthesis of over 260 systematic reviews on stigma reduction and presents a detailed summary of the global evidence on how to reduce stigma and discrimination (building on earlier findings of the Lancet Commission on Ending Stigma and Discrimination in Mental Health). This review examined evidence regarding intervention impacts and summarizes key findings. Notably, this global review indicates that interventions based on the principle of social contact (whether in person, virtual, or indirect), that have been appropriately adapted to different contexts and cultures, are the most effective ways to reduce stigmatization worldwide.
The Cost of Inaction: Quantifying the Impact of Climate Change on Health in Low- and Middle-Income Countries
(Washington, DC: World Bank, 2024-11-15) World Bank
Climate change is impacting human health in myriad ways, including by increasing the frequency of extreme weather events, the emergence and spread of infectious diseases, and disruptions to food systems. The impacts of climate change on health—already profound—are only expected to worsen over time. Not only will the number of diseases and deaths from climate-sensitive health risks increase, but so too will the geographical range of these diseases. Low- and middle-income countries (LMICs) are expected to face a disproportionate burden of these impacts due to their higher levels of poverty and income inequality, and weak healthcare systems. With growing recognition that the climate crisis is a health crisis, the international community has expressed urgent calls for action on climate and health. The response of the health community and researchers has been largely focused on studying the link between climate change and health. A limited number of studies have established empirical links between climate conditions and the number of cases of different diseases in specific national (or subnational) contexts, particularly focusing on vector-borne and waterborne diseases. In addition, few studies have aimed to assess the economic cost associated with the health impacts of projected climate change. This report aims to address the existing knowledge gap and provide a deeper understanding of the interconnection between climate and health, in terms of the risks to human health and the economic burden of these risks. Specifically, it provides a quantitative assessment of the potential impacts of climate change based on the number of cases and the number of deaths resulting from selected vector- and water-borne diseases, stunting, and extreme heat. An assessment of the economic cost of climate change on health (in terms of both morbidity and mortality) is also provided. The analysis covers 69 LMICs with national populations exceeding 10 million people in the base year 2020. These 69 countries comprise 96 percent of the tota population of all LMICs.
Unlocking the Power of Healthy Longevity: Compendium of Research for the Healthy Longevity Initiative
(Washington, DC: World Bank, 2024-09-12) World Bank
Noncommunicable diseases (NCDs) are among the major health and development challenges of our time. Every year, about 41 million people die due to NCDs. This makes up about 74 percent of all deaths globally, the majority of which are in low- and middle-income countries (LMICs). Countless more people live with NCDs every day. Yet, NCDs are largely treatable and preventable. The risk of developing NCDs and deaths from them can both be lowered with appropriate attention to prevention and treatment. However, weak health systems and limited access to affordable care and information, especially in LMICs, contribute to lapses in seeking and receiving appropriate and timely care. This compendium is a compilation of 18 chapters, each exploring a different but related topic in the nexus of NCDs, human capital, and productivity. It is based on a series of analytical work taken up by the World Bank to support the Healthy Longevity Initiative (HLI) - a collaborative effort between the World Bank, the University of Toronto, and key academic and development partners including the Harvard University and the University of Washington. The HLI presents one of a growing set of efforts to increase the urgency of policy response to NCDs across the world.
Unlocking the Power of Healthy Longevity: Demographic Change, Non-communicable Diseases, and Human Capital
(Washington, DC: World Bank, 2024-09-12) World Bank
The World Bank has a long history of engaging in population issues, ranging from childhood illness, nutrition, fertility, and safe motherhood to the aging process. It supports countries in addressing the implications of the demographic process through analytical work, technical advice, and financing to expand health coverage, redesign pension systems and social security, and undertake actions that support their economies. This report follows that tradition and analyzes the steps to promote healthy longevity and enhance the quantity and quality of human capital through attention to the burgeoning problem of Non-communicable diseases (NCDs). Research began before COVID and concluded after, drawing upon lessons from the pandemic. The report is intended to inform policy and action at the country level. The demographic transformation is a global phenomenon, and the increasing population of the middle-aged and elderly brings with it many challenges which are more acute in low- and middle-income countries where resources are more limited. The increasing number of adults calls upon countries to institute the social and economic measures of ensuring their wellbeing and making them optimally productive. Health must be at the center of these concerns, not only its preservation towards the end but its optimization throughout the life-course. This report builds on a compendium of analytical papers covering the economics of avoidable mortality, long-term care, behavior change, social protection, and whole-of-government solutions to support healthy longevity. It emphasizes that a great deal of ill health globally is a result of inequities—especially poverty and gender inequities that limit or delay access to and use of health care. High out-of-pocket payments for NCDs can plunge households further into poverty or extreme poverty. Women live longer with NCD morbidities.