Other Health Study
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Publication
Preventing, Preparing for, and Responding to Disease Outbreaks and Pandemics: Future Directions for the World Bank Group
(Washington, DC, 2023-01-11)This paper has outlined an ambitious agenda for the WBG to support PPR enhancement at country, regional, and global levels as part of a broader approach to strengthen health systems. It is an agenda that not only seeks to deliver on the Bank’s IDA commitments related to disease outbreaks and crisis response but also to respond to demands from all our shareholders, clients, and other stakeholders for the Bank to play a key role in strengthening PPR capacities at country and regional levels through a wider health system strengthening agenda. Policy commitments from IDA’s Human capital special themes support the building of resilient health systems that can provide core essential health services and have the capacity to prevent, detect, and respond to disease outbreaks and other health emergencies an approach that will ensure sustainability, efficiency, and effectiveness. The paper has highlighted that PPR is an inherently multisectoral agenda. Further, the paper has argued that there are large financing gaps to fill, particularly in LICs and MICs. Looking forward, the WBG will support strengthening of PPR through actions in three interconnected domains: 1) financing; 2) global engagements and partnerships; and 3) analytics, evidence, and dialogue. -
Publication
Country Case Study: The Republic of Korea
(Washington, DC: World Bank, 2022-11)This case study aims to describe the Republic of Korea’s preparedness and response to coronavirus disease 2019 (COVID-19) and the resultant impact of the pandemic on the health of its citizens and the economy. Korea has been recording COVID 19-related epidemiological data since January 20, 2020, when the first imported confirmed case of COVID-19 occurred. Since then, Korea has undergone four surge waves, which posed different challenges and cumulative negative impacts. The government implemented and revised social distancing policy measures, as appropriate, to maintain a balance between acceptable risk and disease burden, while promoting vaccination. The fiscal policy also has kept an expansionary stance to cushion the economic effects of the pandemic. The report has four chapters, with subtopics. The Preparedness chapter describes the policy and governance measures, as well as the health care system, that facilitated prompt surveillance and early policy making. The Response chapter describes seven components, including the response of the government, the health system, and the public, to contain COVID-19; vaccination; protecting vulnerable people; innovation through leapfrogging; and measures to contain COVID-19 from a human capital perspective. Each component describes how Korea has dealt with the pandemic. The third chapter emphasizes the impact of the COVID-19 pandemic on the progress of universal health coverage (UHC) and sustainability, and the last chapter discusses lessons learned for the future and for other countries, including best practices and challenges. Korea has been relatively successful in containing the pandemic, reducing its economic impact, and maintaining public trust during the prolonged period. Several factors have contributed to this. The government structure facilitated expedited decision-making and empowered public-private partnership for a timely response, backed by a concrete legal basis and institutional infrastructure. Transparent risk communication and information disclosure, with specific guidelines, allowed redistribution of resources and infection control activities. It is always important to learn from previous experiences to be well prepared for the next crisis. Even if regulations are in place to effectively respond to new infectious diseases, it is necessary to be open to the revisability of the legal framework, depending on the actual situation. Extensive testing and contact tracing combined with flexible social distancing measures are highly effective in containing the spread of infectious diseases and reducing the number of new cases, which in turn helps to alleviate the burden on the health system, until vaccines and medicines are developed and become available. It is important to provide appropriate care for patients, depending on the severity of disease, and to reduce the burden on the health system to minimize mortality. However, it should be borne in mind that policy measures used in Korea such as extensive testing, tracing, and social distancing could not be successful without dedicated health professionals as well as the cooperation of citizens. It is necessary to devise effective communication methods, as the public’s perception of the government’s briefing and text messages deteriorates during a prolonged pandemic. For policy makers, it is necessary to determine an optimal level of social distancing, not only to save as many lives as possible, but also to ensure the livelihood of the citizens. -
Publication
Sustaining Action Against Antimicrobial Resistance: A Case Series of Country Experiences
(Washington, DC, 2022-10-17)Antimicrobial resistance (AMR) occurs when microbes, bacteria, viruses, fungi, and parasites, evolve in ways that reduce medicine’s ability to fight them. AMR has made many infections, particularly bacterial infections, increasingly difficult or even impossible to treat. Without effective medicines, the number of people with severe microbial infections will increase, as will the number of people who die from these infections. In 2019, 4.95 million deaths were associated with AMR, with the highest AMR-attributable death rates occurring in western sub-Saharan Africa.8 While AMR is a natural evolutionary process that occurs over time, many human-led behaviors have increased its occurrence. The main drivers of AMR include: (1) the misuse and overuse of antimicrobials; (2) lack of access to clean water and adequate sanitation for people and animals; (3) poor infection prevention and control measures in healthcare facilities and farms; (4) limited access to quality, affordable medicines, vaccines, and diagnostics; and (5) lack of awareness and knowledge about AMR. Additionally, for countries to progress from planning to acting, AMR coordination committees must have a clearly defined role and the remit to develop and implement an operational plan. Operational plans should embed NAP activities into the national development agenda, sectoral strategies, and budgets, and should coordinate an aligned approach to delivering NAP activities across sectors and stakeholders. Creating and empowering AMR coordination committees and comprehensively implementing and monitoring the prioritized activities outlined in their NAPs operational plan takes time; but there are several relatively easy entry points for AMR action that countries can utilize to accelerate their fight against AMR. The remaining case studies in this series showcase successful actions against AMR that three countries, Burkina Faso, Jordan, and Malawi, have taken along their journey to fully operationalizing and implementing their NAPs on AMR. -
Publication
Putting Pandemics Behind Us: Investing in One Health to Reduce Risks of Emerging Infectious Diseases
(Washington, DC, 2022-10)The COVID-19 crisis brought home the high costs of pandemics, triggering a historic setback in the fight against poverty. It also reinforced the interconnections between people, planet and economy, calling attention to the zoonotic nature of pathogens spilling over from animals to people. To decrease their burden, we must focus on prevention. The One Health approach proposes a way forward to reduce risk of spillover. Recognizing that the health and well-being of humans, animals, and their shared ecosystems are interdependent, One Health is designed as an integrated, practical, multisectoral framework for pandemic prevention. By stopping infectious diseases from spilling over to people and spreading to become pandemics, One Health provides a solid foundation for global health security and improved development outcomes at much lower societal and economic costs. This report aims to shed light on the benefits of prevention to serve as a wake-up call for policymakers and finance ministers alike. The report also outlines an investment framework and One Health architecture for zoonotic disease prevention. As you will read on these pages, compared to the sky-high cost of bringing pandemics under control, relatively modest investments in prevention will pay huge dividends. -
Publication
Innovations Under the China Health Reform Program-for-Results: A Case Study Series
(Washington, DC: World Bank, 2022-08)Since 2009, China has been undertaking an ambitious program of health system reforms. Comprehensive reforms were defined in five priority areas: basic health insurance, health service delivery at grassroots level, essential public health service, an essential drugs program, and public hospital reform. After more than a decade of implementation, these reforms have led to notable achievements; however, challenges remain. The government of China tackled these health system challenges in its Thirteenth Five-Year Plan, the implementation of which was supported by a USD 600 million China Health Program-for-Results between 2018 and 2022. This was one of the first Program-for-Results financed by the World Bank in China and globally. Program-for-Results finances a subset of activities in a broader government program and uniquely links disbursement of funds directly to the achievement of specific program results rather than inputs as in traditional investment projects. In this Program-for-Results, there were three key results areas, aligned to the objectives of the government health reform program: (a) drawing on the reform model in successful pilots to deepen and mainstream comprehensive public hospital reforms; (b) strengthening primary health care services through establishing patient-centered integrated care; (c) addressing cross-cutting dimensions of the policy, institutional, and financial environment, such as information technology, to support the health reforms. This report showcases four case studies of innovations that summarize key lessons and experiences in the implementation of reforms under the Program-for-Results in the two provinces. The selected innovations are drawn across the three results areas of the Program-for-Results and shed light on tackling common health system challenges. The complexity of the health system in China and ambitious nature of its health system reforms combine to set the tone for the case studies, which provide opportunities for in-depth, multifaceted explorations of complex issues in the real-life health care settings. -
Publication
Behavioral Science and COVID-19: An Interactive Solutions Guide for Better Policy Design
(Washington, DC: World Bank, 2022-07-27)The first Coronavirus (COVID-19) cases were reported in December 2019 (WHO, 2020). Governments around the world have tried various interventions to stop the COVID-19 spread and encourage vaccination. With growing evidence of the governments’ COVID-19 efforts to deal with the pandemic, this guide aims to summarize interventions and applications, and their effectiveness to address the following three COVID-19 topics: How to reduce COVID-19 spread; How to encourage people to get vaccinated; and How to address misinformation and fake news. -
Publication
From Reacting to Preventing Pandemics: Building Animal Health and Wildlife Systems for One Health in East Asia and the Pacific
(Washington, DC: World Bank, 2022-06-29)Investing in One Health – cross-sectoral, multidisciplinary coordination and collaboration across the human health, animal health, and environmental health sectors – is crucial for maintaining healthy agricultural and food systems and addressing global health security risks. Such action can reduce the threat of future pandemics through upstream preventive actions, early detection, and agile responses to zoonotic and emerging infectious diseases outbreaks, coupled with measures for promoting food safety, including anti-microbial resistance. This regional review, conducted jointly by the World Bank and the Food and Agriculture Organization of the United Nations, assesses the socioeconomic impacts of zoonotic diseases and epidemics across the East Asia and Pacific region, providing a background on why emerging infectious diseases are occurring more frequently in this region. This review looks at the benefits of using a risk-based approach, assesses the management of animal and wildlife health and the ability to identify and respond to emerging threats and protect the health, agricultural production, and ecosystem services. It provides recommendations on priority activities to be undertaken, and offers governments and their development partners the evidence and analysis needed to make more and better investments in wildlife systems and animal health to improve global health security. -
Publication
Governance of the Service Delivery Chain for Youth Mental Health in Lithuania: Key Findings From a Public Sector Employee Survey
(Washington, DC, 2022-06)There is a youth mental health crisis in Lithuania. Mental health challenges have several delirious consequences for the youth, including poor performance in school and negative outcomes later in life such as substance abuse, poor health, unemployment, and incarceration. Addressing this crisis is a priority for the Government of Lithuania, as documented in several strategic plans and budgetary programs. At the request of the government, the World Bank’s Bureaucracy Lab undertook an empirical diagnostic of the youth mental health service delivery chain, focusing on the education sector. The study was based on a conceptual framework of a production function of youth mental health service delivery. The report is structured to give a comprehensive picture of the governance factors in Lithuania’s mental health services delivery system. Chapter 2 sets forth the conceptual framework used to study the challenge and to design the survey. Chapter 3 charts the results from the study, closely following the designed conceptual framework. Policy recommendations constitute Chapter 4, with actionable proposals given for each tier of the government. -
Publication
Colombia - Evaluación de las Capacidades de Preparación y Respuesta ante Futuras Pandemias y Emergencias en Salud Pública
(Washington, DC: World Bank, 2022-05-31)El sistema de salud en Colombia (SGSSS) se basa en un sistema de aseguramiento que tiene como objetivo garantizar el acceso a los servicios de salud y la protección económica de la población. El SGSSS tiene principalmente dos esquemas de beneficiarios: subsidiado y contributivo 1 . Los beneficiarios de estos regímenes están afiliados a las empresas de aseguramiento (EPS) que los representan y administran sus riesgos de salud coordinando los servicios necesarios, según lo determine el Plan de Beneficios. Este Plan se refiere a la gama elegible de servicios, procedimientos, medicamentos y tecnologías para prevenir, aliviar y tratar enfermedades. Por cada beneficiario, se reconoce y desembolsa a cada EPS, una tasa de prima de salud, la Unidad de Pago por Capitación (UPC). Las EPS organizan su red de prestaciones de servicios y contratan a las Instituciones Prestadoras de Servicios de Salud (IPS), para brindar servicios de salud a sus beneficiarios. Las IPS pueden ser hospitales públicos o privados, servicios de atención ambulatoria o profesionales de la salud por cuenta propia. El sistema de salud se financia principalmente con recursos del Estado central, con recursos adicionales derivados de los aportes de personas y empresas con empleados formales. Otros recursos centralizados son desembolsados a las entidades territoriales para financiar iniciativas de salud pública y complementar el régimen subsidiado. Las entidades territoriales también han destinado ingresos (impuestos a licores y loterías) para atender gastos en salud. La pandemia causada por la expansión a escala global del virus SARS CoV2 y de la enfermedad generada por este agente (COVID-19), ha suscitado una crisis sin precedentes desde la perspectiva sanitaria, social y económica (Organización Panamericana de la Salud, 2020). Tal circunstancia ha develado la necesidad de evaluar hasta qué punto estamos preparados como sociedades, regiones, países, ciudades y municipios para encarar y resistir los efectos devastadores de una epidemia, emergencia o problemática sanitaria de tal magnitud. Por ello, resulta preciso identificar brechas y vacíos en las capacidades de preparación y respuesta identificando el grado de desarrollo de aquellas habilidades, condiciones y potencialidades que resguarden las capacidades de operación de los sistemas de salud y permitan responder efectivamente a estas adversidades. -
Publication
Bottlenecks in Anemia Prevention and Control in the West Bank and Gaza Strip: Assessment Report
(Washington, DC: World Bank, 2022-05-04)According to the information available and the thresholds established by World Health Organization (WHO)E, anemia is a public health problem among the most vulnerable groups in the Palestinian Territory, namely pregnant and postpartum women, children aged between 6-59 months, and adolescents aged 15-18 years. The burden of anemia has remained static during the last decade, suggesting that the anemia prevention and control (APC) interventions in place have not produced their expected outcomes. This assessment, therefore, identifies and analyzes bottlenecks in the ongoing interventions to provide insights to strengthen APC in the West Bank and Gaza Strip (WB & GS). The three main APC activities identified in the Palestinian Territory were the universal fortification of wheat flour with micronutrients, iron supplementation to pregnant and postnatal women and children aged between 6-23 months, and the promotion of an increased dietary intake of micronutrients.