Health Sector Review

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  • Publication
    The Primary Health Care System in Fiji: A Primary Health Care Performance Initiative Assessment
    (Washington, DC: World Bank, 2024-01-22) World Bank Group
    This report presents the findings of the Vital Signs Profile (VSP) assessment conducted by the World Bank and the Primary Health Care Performance Initiative (PHCPI) in collaboration with Fiji’s Ministry of Health and Medical Services (MHMS). The VSP provides an opportunity to assess the state of the primary health care (PHC) system in Fiji, highlighting areas of strength and challenges through the lens of the PHCPI framework. The framework organizes various domains and subdomains of primary health care using a logic model approach that encompasses the traditional inputs and outputs of PHC systems and emphasizes the capacity and processes of PHC service delivery and performance. Notably, while PHCPI recognizes the role of social determinants of health and intersectoral health promotion and prevention efforts as important factors influencing population health, the VSP is primarily focused on aspects of health service delivery. Fiji is one of four Pacific countries - alongside Kiribati, the Republic of the Marshall Islands, and Solomon Islands that have, with support of the World Bank, used PHCPI tools to take stock of current performance, safeguard what works well, and lay out a vision for areas requiring improvement.
  • Publication
    Reshaping Ukraine's Health Service Delivery: Vision and Investment Needs
    (Washington, DC: World Bank, 2024-01-11) World Bank
    The full-scale invasion of the Russian Federation in Ukraine has immense local impact and global consequences. Ukraine is experiencing huge human and economic suffering, which will have long-lasting effects. This war has been particularly devastating for the Ukrainian health sector, tremendously increasing the urgent need for specific services and simultaneously obstructing health outcomes and access to health care due to hostilities, disruption of service delivery, and damage and destruction of health facilities. Moreover, the recovery of Ukraine is shrouded in uncertainty as the duration of the ongoing war and the frequency and localization of the attacks are unknown, all occurring against the backdrop of economic challenges within the country and at a global scale. Despite an expected international effort to finance the recovery of Ukraine akin to the Marshall Plan, financial resources may not be easily available or may become more scarce and more expensive. Investments will receive more scrutiny, and competition for funds will increase due to monetary tightening, rising interest rates, and possibly sustained high inflation (International Monetary Fund 2022). However, in the short to medium term, Ukraine is expected to have favorable access to international financing on concessional terms.While Ukraine is struggling with the gruesome immediate impact of the war and a fight for survival, the shared understanding emerges that going back to business as usual will neither be possible nor desirable. This moment may also serve as a window of opportunity for rapid reform and innovation of health service delivery in Ukraine. Improving and reconstructing services while restoring and stabilizing them is critical to aiding a suffering population and to laying strong foundations of governance that will have lasting impacts into the country’s future. This document provides a proposal for stakeholdersin the Ukrainian health sector on how service delivery may need to change, how to deal with this change, and how the health sector may come out stronger in the longer term. It focuses on the organization of health care service delivery and shares considerations of how it may develop using a long-term (10+ years) perspective.
  • Publication
    The Primary Health Care System of the Republic of the Marshall Islands: A Primary Health Care Performance Initiative Assessment
    (Washington, DC: World Bank, 2024-01-05) World Bank Group
    This report presents the findings of the primary health care (PHC) system in the Republic of the Marshall Islands (RMI), an assessment that the World Bank conducted in consultation with the Ministry of Health and Human Services (MHHS) of the government of RMI. The assessment provides an opportunity to understand the performance of RMI’s PHC system, highlighting important areas of strengths and opportunities to address ongoing challenges. The assessment uses the Primary Health Care Performance Initiative (PHCPI) framework, which organizes various domains and subdomains of primary care using a logic model approach that encompasses the traditional inputs and outputs of a system, emphasizing service delivery and performance.
  • Publication
    The Primary Health Care System of the Republic of Kiribati: A Primary Health Care Performance Initiative Assessment
    (Washington, DC: World Bank, 2024-01-05) World Bank Group
    The assessment of Kiribati’s primary health care (PHC) system, carried out by the World Bank in collaboration with the Government of Kiribati under the Primary Health Care Performance Initiative (PHCPI), marks a unique opportunity to identify the system’s strengths and gaps and to catalyze further improvements. The PHCPI tools, including the Vital Signs Profile (VSP) methodology, provide important insights into the country’s PHC system and generate actionable policy recommendations for improvement.
  • Publication
    The Role of Belize’s Primary Health Care System in Pandemic Preparedness and Response: A Qualitative Study
    (Washington, DC: World Bank, 2023-10-17) World Bank Group
    While the incidence of COVID-19 in Belize has subsided, the lasting health and economic impacts caused by the pandemic have demonstrated the need to build a resilient health system. The most recent figures from the Statistical institute of Belize confirm that there have been over 60,000 cases and 678 deaths due to COVID-19. Additionally, a rapid phone survey of over 2,000 households, conducted between December 2021 and January 2023, found that 20.6 percent and 26.8 percent of respondents reported losing their job permanently or temporarily, respectively, and an additional 64 percent of respondents reported a reduction in their income during pandemic. Ensuring the health system remains resilient to shocks is critical, especially given the pandemic’s impacts on heath and the economy.
  • Publication
    The Primary Health Care System of Moldova: A Primary Health Care Performance Initiative Assessment
    (Washington, DC: World Bank, 2023-10-17) World Bank Group
    This report presents the findings of the primary health care (PHC) system assessment in the Republic of Moldova undertaken by the World Bank in collaboration with the Moldovan government and under the leadership of the Ministry of Health (MoH). It highlights existing strengths, identifies areas in need of improvement, and suggests strategies for system strengthening.
  • Publication
    The Primary Health Care System of the Gambia: A Primary Health Care Performance Initiative Assessment
    (Washington, DC: World Bank, 2023-10-17) World Bank Group
    The results of the assessment point to four policy recommendations to address challenges related to governance, availability of medicines and supplies, comprehensiveness of services, and ability to deliver adolescent sexual and reproductive health (ASRH) services and promote universal and effective PHC coverage in The Gambia: 1.Establish a PHC-specific policy focused on improving coordination across governmental and non-governmental actors, quality of care, and monitoring and evaluation. 2. Increase the availability of medicines and supplies by leveraging. existing purchasing mechanisms and strengthening supply chain management. 3. Implement a people-centered model of PHC focused on delivering comprehensive infectious and NCD services. 4. Increase capacity for adolescent sexual and reproductive health service delivery.
  • Publication
    Fidelity and Sustainability in the Implementation of the Integrated Networks for the Provision of Health Services of the Huetar-Atlántica Region, Costa Rica
    (Washington, DC: World Bank, 2023-10-17) World Bank Group
    The aim of this report is to document the fidelity of the implementation of the RIPSS in the Huetar-Atlántica Region in Costa Rica. Implementation fidelity seeks to assess the extent to which an intervention is implemented as planned and, for this, the PIPs were contrasted with what was implemented in practice. The assessment identified the following: (i) gaps in the implementation that require subsequent actions, and (ii) the core elements for the sustainability and scale-up of the RIPSS.
  • Publication
    A Way Forward for Building Resilient Health Systems: Lessons Learned from Eastern Europe and the South Caucasus
    (Washington, DC: World Bank, 2023-08-01) Koziel, Anna; Nguyen, Ha Thi Hong; Gonzalez-Aquines, Alejandro
    This report looks at resilience through national health system lenses and provides lessons to strengthen health systems for future shocks. The findings are based on case studies from five countries in Eastern Europe and the South Caucasus (Armenia, Azerbaijan, Georgia, Moldova and Ukraine), as well as focus group discussions with the population and health care workers in Georgia, Armenia, and Moldova. The following section provides the definition and examples of health system resilience. This is followed by descriptions of the baseline characteristics of the five Eastern European and South Caucasus countries’ health systems pre-pandemic performance, which determined most of their capacity and decisions to deal with the shock. The rest of this report reviews key baseline characteristics of the health systems in the countries, which are followed by lessons from the countries’ responses to the pandemic (a summary of each country case study is provided in Annex A). The report concludes with recommendations for building the strong and resilient health systems needed to protect human capital through shocks and crises.
  • Publication
    The Economic Burden of SARS-CoV-2 Infection Amongst Health Care Workers in the First Year of the Pandemic in Kenya, Colombia, Eswatini, and South Africa
    (Washington, DC: World Bank, 2023-07-24) Wang, Huihui; Munge Kabubei, Kenneth; Rasanathan, Jennifer; Kazungu, Jacob; Ginindza, Sandile; Mtshali, Sifiso; Salinas, Luis E.; McClelland, Amanda; Buissonniere, Marine; Lee, Christopher T.; Chuma, Jane; Veillard, Jeremy; Matsebula, Thulani; Chopra, Mickey
    Health care workers (HCWs) face disproportionate risk of exposure and becoming ill in any infectious disease outbreak. SARS-CoV-2 has proven to be no exception: From Wuhan to Manaus, London to Tehran, and Delhi to Johannesburg, HCWs working in clinics and hospitals have been at heightened risk of developing COVID-19 disease, especially at the beginning of the pandemic when little was known about the then-novel pathogen. This study thus aims to estimate the economic costs of SARS-CoV-2 infections in HCWs during the first year of the pandemic from the societal perspective in four low or middle- income countries. The authors propose a framework to translate SARS-CoV-2 infection amongst HCWs into economic costs along three pathways, provide the estimated burden of HCW infections, and offer recommendations to mitigate against future economic losses due to HCW infections. The economic burden due to SARS-CoV-2 infection among HCWs makes a compelling investment case for pandemic preparedness, particularly the protection of HCWs, and resilient health systems going forward.