Person:
Secci, Federica
Author Name Variants
Fields of Specialization
Health management and policy,
Quality of care,
Performance measurement,
Behavior change
Degrees
ORCID
Departments
Global Practice on Health, Nutrition and Population, The World Bank
Externally Hosted Work
Contact Information
Last updated
January 31, 2023
Biography
Federica Secci is a Health Specialist in the Global Engagement unit of the HNP Global Practice. She joined the Bank as a Young Professional in 2013 and has supported operations and analytical work across different countries and regions, including Afghanistan, Bangladesh, Chile, India, and Vietnam. She currently works on the Primary Health Care Performance Initiative (PHCPI), a partnership launched in 2015 to improve measurement and use of data in PHC, and for which she co-leads the country engagement work stream. Prior to the Bank, Federica was a Research Fellow at Imperial College London, focusing mostly on quality of care and behavior change related to infection prevention and control in hospitals. Federica's doctoral research was a comparative, qualitative analysis of the PHC reforms in Estonia and Lithuania drawing from sociology and institutional theory. Federica also contributed to systematic reviews looking at integration of vertical programs into PHC.
Publication Search Results
1 - 10 of 10
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Bhutan : Maternal and Reproductive Health at a Glance
(World Bank, Washington, DC, 2014-11)Bhutan is a small landlocked country in the Himalayas between China and India. Poverty reduction has been rapid from about 23 percent in 2007 to 12-13 percent in 2012. Gender equality and women's empowerment are important determinants of reproductive health. Contraceptive prevalence rate (CPR) is higher among the poorest quintile than the richest. Large disparities in access to skilled birth attendant remain by geography and wealth quintile. Poor nutrition is a serious issue for pregnant mothers, since 55 percent of women are anemic. Bhutan will need to focus on increasing the focus on quality along the continuum of care; improving access and equity; and ensuring sustainability of health financing. -
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Bangladesh : Maternal and Reproductive Health at a Glance
(World Bank, Washington, DC, 2014-11)Bangladesh is among the most densely populated countries in the world. Poverty remains high at 43 percent of the population subsist on less than United States (U.S.) $1.25 per day (2010). Bangladesh achieved several millennium development goal (MDG) targets in education, health, and poverty reduction. Gender equality and women's empowerment are important determinants of reproductive health. While fertility and contraceptive prevalence rate (CPR) are evenly distributed, wide gaps in access to maternal health services remain. Bangladesh will need to focus on increasing political commitment to adolescent health; focusing interventions on high-fertility and high maternal mortality ratio (MMR) areas; addressing human resources constraints; and harnessing the use of technology. -
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India : Maternal and Reproductive Health at a Glance
(World Bank, Washington, DC, 2014-11)India is the third largest economy and has the second largest population in the world. It achieved millennium development goal (MDG) on poverty reduction; however, gender inequality still persists. Maternal mortality rate is 190 deaths per 100,000 live births, representing a 65 percent decline from 1990. Fertility fell to 2.5, while contraceptive prevalence rate increased to nearly 55 percent. Seventy-four percent of women sought antenatal care (ANC) from a qualified provider and 52 percent of births were attended by qualified providers. Wide gaps in contraceptive prevalence rate (CPR) and access to skilled-birth attendance remain by geography and wealth quintile. India will focus on preventing unwanted pregnancies especially among adolescents; improving demand-side strategies; strengthening access and quality in public and private sectors; improving antenatal, intranatal, and postnatal care; strengthening monitoring and evaluation (M and E) systems and reducing inequities; and improving nutrition. -
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Nepal: Maternal and Reproductive Health at a Glance
(World Bank, Washington, DC, 2014-11)Nepal has made a remarkable progress in achieving the Millennium Development Goals (MDGs), especially in extreme poverty and education. Nepal has achieved MDG 5 but only one in three births is attended by skilled medical personnel. Disparities exist in access to maternal care by residence and wealth quintiles. The total fertility rate has declined to 2.4 in 2012, along with increased contraceptive use at 50 percent. High unmet need of 27 percent still remains. Nutritional deficiencies for pregnant and lactating women remain a challenge. Nepal has initiated a number of key interventions to respond to increased adolescents needs for health services, improve accessibility and quality of services at local level, and enhance equitable access to services through micro-planning exercise and provision of financial protection. -
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Maldives: Maternal and Reproductive Health at a Glance
(World Bank, Washington, DC, 2014-11)Maldives, a middle income country, is on track to meet most of the Millennium Development Goals (MDGs), while gender gap requires attention. Maldives has made great progress in improving maternal health and has achieved MDG. The total fertility rate has declined to 2.3 in 2012. Contraceptive use has increased but high unmet need of 28.1 percent is of concern. Skilled birth attendance is high at 95 percent. Access to maternal health services is fairly equitable by residence and wealth quintile, while geographical access to services remains challenging. Also, unwanted pregnancies among young women are on the rise. Maldives has initiated a number of interventions to increase adolescents needs for sexual and reproductive health services, improve quality of RMNCH services, and increase utilization of health services at local level. -
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Clearing the Global Health Fog : A Systematic Review of the Evidence on Integration of Health Systems and Targeted Interventions
(World Bank, 2009-03-01)A longstanding debate on health systems organization relates to benefits of integrating health programs that emphasize specific interventions into mainstream health systems to increase access and improve health outcomes This paper is organized in five chapters. This introduction is followed by the methodology chapter, which includes a brief section on the conceptual framework used to analyze the studies retrieved and the programs presented within these to map the nature and extent of integration into critical health system functions. The results chapter includes: a summary of the outcomes for each study grouped by the disease area or the clinical problem the intervention seeks to address, including the reported success; for each program, analysis and mapping of the nature and extent of integration into critical health system functions; and an analysis of how contextual factors either created opportunities for introducing or integrating a program or influenced the desirability or feasibility of program integration. The discussion chapter provides an overview of the implication of findings for policy makers, practitioners and researchers. The final chapter draws conclusions. -
Publication
Primary Health Care in the World Bank’s COVID-19 Multiphase Programmatic Approach Portfolio Response: The Extent to Which Pandemic Response Activities Were Planned at the Primary Health Care Level within the World Bank’s COVID-19 MPA Projects
(World Bank, Washington, DC, 2022-06)Soon after the World Health Organization (WHO) declared a pandemic, the World Bank made available rapid financing to strengthen countries' ability to respond to COVID-19 through a multiphase programmatic approach (MPA). The MPA's immediate objective is to prevent, detect, and respond to the COVID-19 pandemic. By July 2020, the World Bank’s board of directors had approved financing for 74 countries. This evaluation aims to determine the extent to which response activities were planned at the primary health care (PHC) level, and the extent to which PHC was leveraged within the first wave of MPA projects was determined by the number of PHC activities listed in the project components and indicators. Of 74 projects evaluated, 70 (94 percent) had at least one PHC-related activity listed in the components. Frequently planned activities at the PHC level primarily included surveillance, handwashing, and community engagement–related activities. MPA projects did not prioritize a commitment to maintaining essential service delivery at the PHC level. Several projects showed a greater commitment to integrating response activities at the PHC level, including Côte d’Ivoire, Egypt, Liberia, and Papua New Guinea, Senegal, the Republic of Congo. Notably, except for Egypt and Papua New Guinea, these projects were in countries that have been affected or threatened by the Ebola pandemic. These countries emphasized the integration of pandemic response activities at the community level. Overall, this evaluation highlights three takeaways: (1) the most common project activities related to PHC focused on surveillance, community engagement, and disease prevention; (2) among MPA projects, those in the sub-Saharan African region integrated more pandemic response activities at the PHC level than did other regions; and (3) maintaining essential primary health care services was not a priority among MPA projects in the initial phase of the response. -
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Health and Nutrition in Urban Bangladesh: Social Determinants and Health Sector Governance
(Washington, DC: World Bank, 2018)Urbanization is occurring at a rapid pace in Bangladesh, accompanied by the proliferation of slum settlements, whose residents have special health needs given the adverse social, economic, and public environmental conditions they face. Over the past 45 years, the country’s health and nutrition policies and programs have focused largely on rural health services. Consequently, equitable access of urban populations—particularly the urban poor—to quality health and nutrition services has emerged as a major development issue. However, the knowledge base on urban health and nutrition in Bangladesh remains weak. To address the knowledge gap, Health and Nutrition in Urban Bangladesh: Social Determinants and Health Sector Governance examines the health and nutrition challenges in urban Bangladesh—looking at socioeconomic determinants in general and at health sector governance in particular. Using a mixed methods approach, the study identifies critical areas such as financing, regulation, service delivery, and public environmental health, among others that require policy attention. The study also proposes specific actions within and outside the health sector to address the issues, providing guidance on their sequencing and the specific responsibilities of government agencies and other actors. This study should be useful to policy makers and practitioners working on urban health and nutrition issues in Bangladesh and in other low- and middle-income countries. -
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A Systematic Review of the Evidence on Integration of Targeted Health Interventions into Health Systems
( 2010)In this paper we present findings of a systematic review that explores a broad range of evidence on: (i) the extent and nature of the integration of targeted health programmes that emphasize specific interventions into critical health systems functions, (ii) how the integration or non-integration of health programmes into critical health systems functions in different contexts has influenced programme success, (iii) how contextual factors have affected the extent to which these programmes were integrated into critical health systems functions. Our analysis shows few instances where there is full integration of a health intervention or where an intervention is completely non-integrated. Instead, there exists a highly heterogeneous picture both for the nature and also for the extent of integration. Health systems combine both non-integrated and integrated interventions, but the balance of these interventions varies considerably. -
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Integration of Targeted Health Interventions into Health Systems : A Conceptual Framework for Analysis
( 2010)The benefits of integrating programmes that emphasize specific interventions into health systems to improve health outcomes have been widely debated. This debate has been driven by narrow binary considerations of integrated ( horizontal) versus non-integrated ( vertical) programmes, and characterized by polarization of views with protagonists for and against integration arguing the relative merits of each approach. The presence of both integrated and non-integrated programmes in many countries suggests benefits to each approach. While the terms 'vertical' and 'integrated' are widely used, they each describe a range of phenomena. In practice the dichotomy between vertical and horizontal is not rigid and the extent of verticality or integration varies between programmes. However, systematic analysis of the relative merits of integration in various contexts and for different interventions is complicated as there is no commonly accepted definition of 'integration'-a term loosely used to describe a variety of organizational arrangements for a range of programmes in different settings. We present an analytical framework which enables deconstruction of the term integration into multiple facets, each corresponding to a critical health system function. Our conceptual framework builds on theoretical propositions and empirical research in innovation studies, and in particular adoption and diffusion of innovations within health systems, and builds on our own earlier empirical research. It brings together the critical elements that affect adoption, diffusion and assimilation of a health intervention, and in doing so enables systematic and holistic exploration of the extent to which different interventions are integrated in varied settings and the reasons for the variation. The conceptual framework and the analytical approach we propose are intended to facilitate analysis in evaluative and formative studies of-and policies on-integration, for use in systematically comparing and contrasting health interventions in a country or in different settings to generate meaningful evidence to inform policy.