Other Health Study
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Publication
Financing of Essential Public Health Services in the Caribbean Region: Case Study
(Washington, DC: World Bank, 2023-09-21)This study examines the expenditure by Caribbean Community (CARICOM) countries on the delivery of Essential Public Health Services (EPHS), in the context of the global response to COVID-19. In particular, the study focuses on financing arrangements enacted to ensure the predictability of funding and the sustainability in the level and flow of funds over the medium and long terms to carry out essential public health functions in Barbados, Grenada, Jamaica, and Trinidad and Tobago. The study also highlights the close, synergistic relationship between the Caribbean Public Health Agency (CARPHA) and its Member States. -
Publication
Ghana’s Pharmacovigilance Experience: From Vertical Program Activity to Nationwide System
(Washington, DC: World Bank, 2023-09-21)The objective of this report is to examine the development of pharmacovigilance (PV) in Ghana and illustrate the role it plays in the health system, and more recently, during the COVID-19 emergency response. It concludes by offering some relevant lessons for building PV capacity in other low-and middle-income countries. -
Publication
Tracking Universal Health Coverage: 2023 Global Monitoring Report
(Washington, DC: World Bank, 2023-09-18)Leaving no one behind is a central promise of the 2030 Agenda for Sustainable Development, which recognizes health as a fundamental human right. Achieving Universal Health Coverage (UHC) is key to delivering on this promise. UHC ensures that everyone receives good quality health services, when and where needed, without incurring financial hardship arising from payments made for those services. The 2023 Universal Health Coverage Global Monitoring Report presents an alarming picture of stagnating access to essential health services and increased financial hardship from out-of-pocket health payments affecting especially the poorest and most vulnerable people. Globally, about 4.5 billion people, more than half of the world population, lack full access to essential health services. Since 2015, health service coverage has stagnated after a dynamic increase in previous years, indicating that urgent action is required by governments to ensure people can access health services. Past progress in service coverage was largely driven by improved access to infectious disease services, but since 2015 there has been minimal to no expansion of health service coverage related to infectious and noncommunicable diseases or for reproductive, maternal, newborn, and child health services. Financial hardship due to out-of-pocket health spending continues to worsen and undermine efforts to eradicate poverty globally. The number of people incurring catastrophic out-of-pocket health spending (more than 10% of their household budget) increased to more than 1 billion people in 2019, or almost 14% of the global population. About 1.3 billion people (almost 17% of the global population) were pushed or further pushed into poverty by out-of-pocket health spending. This includes 344 million people living in extreme poverty. Out-of-pocket health payments reduce the ability of households to afford other essential goods and services and negatively affect a family’s consumption levels. Health costs also cause individuals to forgo essential care, which can lead to more severe illnesses or even death. Reaching the goal of UHC by 2030 requires substantial public sector investment and accelerated action by governments and development partners, building on solid evidence. This includes strengthening health systems based on a primary health care approach and advancing equity in both the delivery of essential health services and financial protection. Achieving UHC also requires modern, fit-for-purpose health information systems that provide timely and reliable data to inform policy design. Such shifts are essential following the pandemic’s impact on health systems and health workers and in view of deepening macroeconomic, climate, demographic, and political trends which threaten to reverse hard-won health gains around the world. -
Publication
The Impact of Health Taxes in Armenia
(Washington, DC: World Bank, 2023-09-14)This report has been prepared by the World Bank, at the request of the MoH, to support ongoing efforts to improve population health and revenue mobilization in the sector. The study estimates the health impacts of increasing taxation on SSBs, alcohol, and tobacco across gender and income-quintiles. The revenue potential of these taxes is also explored. The target audience for these findings includes senior policymakers and technical advisers in the MoH, Ministry of Economy, and Ministry of Finance (MoF).The remainder of this report is organized as follows. In Chapter 2, the authors reviewthe current state of health and consumption taxes in Armenia. Chapter 3 outlines themethods used to estimate the change in tax revenue and consumption of alcohol,tobacco, and SSBs. Chapter 4 reports the analysis results, including the potentialadditional fiscal space and health gains. Finally, chapter 5 presents the conclusionsbased on the findings. -
Publication
Private Sector Engagement for Noncommunicable Disease Control in Republika Srpska and the Federation of Bosnia and Herzegovina: Current Scope and Policy Options
(Washington, DC: World Bank, 2023-09-14)This report aims to assess the current role and scope of private health care provision for non-communicable diseases (NCDs) in Republika Srpska and Federation of Bosnia and Herzegovina (Federation of BiH). Over the last decade, the Ministry of Health and Social Welfare in the Republika Srpska and the Federal Ministry of Health have implemented municipal initiatives to reduce NCD risk factor exposure and formulate an action plan for NCD control. These efforts have been supported by development partners, including the Swiss Agency for Development and Cooperation (SDC), the World Bank, and the World Health Organization (WHO). The assessment recommends actions that the health authorities in Republika Srpska and the Federation of BiH can take to better engage private providers in tackling NCDs. In mixed health systems, improving NCD prevention and control requires effective partnerships between the public and private sector and establishing an effective regulatory and financialcontext to contribute to progress towards Universal Health Coverage. -
Publication
Sistemas de gestión de información en salud en el Perú
(Washington, DC: World Bank, 2023-08-29)Los Sistemas de Gestión de Información en Salud (SGIS) se han convertido en un instrumento elemental para la operación óptima de los sistemas de salud a nivel mundial. El Perú está desplegando esfuerzos por impulsar el avance de los SGIS y enfrenta grandes desafíos. Este documento busca sintetizar el diagnóstico y la ruta para solucionar los factores que inhiben el desarrollo saludable de los SGIS en el Perú. La propuesta está centrada en contribuir a la implementación de un SGIS que apoye al Sistema Nacional de Salud (SNS) a brindar un efectivo cuidado a la salud de las personas. Este cuidado se evalúa en términos de cobertura y calidad, acorde a las políticas de protección social del estado peruano. Desde esa perspectiva y siguiendo la dualidad de los SGIS en cuanto a sistemas administrativos y asistenciales, se plantea ese doble rol: como soporte (i) de las decisiones vinculadas a una mejor gestión administrativa de los recursos, la logística y el financiamiento y, por otro lado, (ii) de la prestación de servicios de salud, que evoluciona a un papel cada vez más protagónico, en la gestión clínica a través de la Historia Clínica Electrónica (HCE) y otras estrategias e instrumentos en el marco de la transformación digital. La estructura del documento, incluyendo el diagnóstico y recomendaciones, se da a lo largo de cinco capítulos. Luego de un primer capítulo introductorio, el Capítulo II: Antecedentes plantea una línea de base para el sector y los SGIS sobre la cual se desarrolla el resto del análisis. En el Capítulo III: Descripción de los SGIS en el Perú, se realiza descripción del estado de los SGIS en el Perú ahondando en la evolución de las reformas planteadas y los nudos críticos enfrentados. Los Capítulos IV y V realizan el diagnóstico y recomendaciones, respectivamente siguiendo la organización por componentes de un SGIS: Infraestructura, Infoestructura, Recursos Humanos, Utilización de Información y Gobernanza. -
Publication
Silver Opportunity: Case Studies - Time to Focus on Healthy Aging: Challenges, Opportunities, and Recommendations for Bangladesh
(Washington, DC: World Bank, 2023-08-24)Bangladesh is home to one of the largest populations of older adults in the world. Driven by increasing life expectancy at birth, this population is increasing. By 2040,one in five Bangladeshis will be 60 years old or older. The increase in lifespan isaccompanied by a greater burden of noncommunicable diseases (NCDs), whichaccount for 70 percent of all deaths in the country. These chronic conditions tend toaffect older adults, leading to an increased demand for health care services by thisgroup. NCDs are also expensive to treat, placing financial hardship on families in low resource settings. While the Government of Bangladesh has committed to providing many of the basic rights of older adults, the health care needs of older adults remain unmet. A lack of adequate funding and services point to a need for a health care system that caters to the specific needs of older adults, such as long-term care and consolidation of care. Other supportive structures also appear to be missing, such as a health insurance fund that covers common chronic conditions faced by older adults, which would remove barriers to accessing health care. A bill proposing a pension scheme is currently undergoing approval in Bangladesh’s legislative system. The primary health care (PHC) system, too, is geared toward the treatment of acuteillnesses rather than providing older Bangladeshis with integrated, long-term, people centered care. This study aimed to better understand the current capacity of PHC inBangladesh to provide care oriented towards older persons. The authors carried outa desk review of global and Bangladeshi literature on aging populations, followed bystakeholder consultations and key informant interviews with government officials,health professionals, and developmental organizations. Field visits to PHC facilitieswere also carried out to assess whether they met the internationally accepted criteriafor age-friendly infrastructure. The data were compiled and analyzed according to theFIRE framework (Financing, Innovation, Regulation, Evaluation) for older adult care.Despite the large burden of NCDs, only USD0.82 is spent per capita on NCD control,much lower than the USD1.50 recommended by the World Health Organization(WHO). Increasing spending on NCD management can help alleviate the financial pressure on households to care for older adults. -
Publication
Why is the Safety of Medicines Important for Resilient Health Systems? A Synthesis Report
(Washington, DC: World Bank, 2023-08-22)This report discusses the importance of pharmacovigilance (PV) in contributing to building up resilient health systems. It is based on and summarizes the findings of a review of available literature on the topic and relevant case studies focusing on a set of country and regional experiences. Although indispensable in improving health outcomes, the administration and use of medicines may produce adverse reactions, requiring continuous monitoring to ensure that the benefits outweigh the risks. PV, which involves the systematic detection, reporting, assessment, understanding, and prevention of adverse drug reactions (ADRs), is an essential public health function, but it is often overlooked. The review suggests that successful PV programs are built on three essential pillars: statutory provisions that establish standards for PV centers and programs, well-trained health professionals and associated stakeholders, and engaged PV reporters using effective reporting systems. These pillars allow PV programs to be effective in three core activities: reporting adverse drug events (ADEs) and identifying signals, determining threats through a benefit-risk balance analysis, and taking appropriate actions. This is in addition to supporting various functions of a health system, such as national drug policy and regulation, the delivery of medical care, specific disease control programs, increasing the trust of the general public in the system, and promoting eco-PV. Aided by emerging opportunities for development through automation and machine learning, PV programs show immense potential to enhance the monitoring of patient safety and improve the use of medicines. The report offers policy considerations for countries and international partners in building PV capacity as an essential public function of a health system. -
Publication
Digital-in-Health: Unlocking the Value for Everyone
(Washington, DC: World Bank, 2023-08-18)Technology and data are integral to daily life. As health systems face increasing demands to deliver new, more, better, and seamless services affordable to all people, data and technology are essential. With the potential and perils of innovations like artificial intelligence the future of health care is expected to be technology-embedded and data-linked. This shift involves expanding the focus from digitization of health data to integrating digital and health as one: Digital-in-Health. The World Bank’s report, Digital-in-Health: Unlocking the Value for Everyone, calls for a new digital-in-health approach where digital technology and data are infused into every aspect of health systems management and health service delivery for better health outcomes. The report proposes ten recommendations across three priority areas for governments to invest in: prioritize, connect and scale. -
Publication
The Value of Pharmacovigilance in Building Resilient Health Systems Post-COVID: Overview Report
(World Bank, Washington, DC, 2023-08-15)Although indispensable for improving health outcomes, medicines and vaccines or their administration and use can produce adverse effects, requiring continuous vigilance to ensure that the benefits outweigh the risks. Monitoring the safety of the use of marketed medicines and vaccines, also known as pharmacovigilance, should therefore become much more explicit in efforts to strengthen health systems and prepare for public health crises and normal times because the world is determined to build back better after the COVID-19 pandemic. The objective of this report is to examine the importance of pharmacovigilance in a health system both during a health crisis and in normal times, describe the function, structure, and processes of a functional pharmacovigilance system, and explain the value of drug safety monitoring in building resilience in health systems post-COVID-19 pandemic.