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Bruce Summers

Posted Publication: Strategic Investment for Health System Resilience: A Three-Layer Framework on Documents

Publication: Strategic Investment for Health System Resilience: A Three-Layer Framework from the World Bank Group Open Knowledge Repository

Abstract

As efforts to build emergency-ready health systems intensify across the globe, Strategic Investment for Health System Resilience: A Three-Layer Framework provides a practical investment framework and a diverse set of country cases to inform decision-making and strategic resource allocations. The framework includes layer 1, risk reduction—promoting emergency-ready primary health care, public health, prevention, and community preparedness; layer 2, detection, containment, and mitigation capabilities; and layer 3, advanced case management and surge response. This three-layer framework prioritizes interventions that prevent a public health threat from developing in the first place (layer 1), limit its spread should one emerge (layer 2), and manage a widespread crisis that compromises a health system’s ability to deliver care sustainably (layer 3). All three layers play a role in achieving health system resilience, but not all of them have been leveraged equally in the past. Strategic Investment for Health System Resilience offers a glimpse of the relatively low cost of investments in improving the operation of the weakest parts of the three layers. Layer 1 functions are estimated to cost between US$2 per capita in low-income countries and US$4 per capita in lower-middle-income countries. The framework applies equally to short-term epidemics of communicable diseases and to slow-moving trends in noncommunicable diseases. The pace of the needed response to health threats can vary, but all require a system that is resilient across multiple layers of response. Although there is no universal blueprint for every setting, it behooves all countries to seize the moment and invest in the three layers in ways that fit their needs.

Citation

“Zhao, Feng; Kovacevic, Rialda; Bishai, David; Weintraub, Jeff; eds.. 2024. Strategic Investment for Health System Resilience: A Three-Layer Framework. Human Development Perspectives. © Washington, DC: World Bank. http://hdl.handle.net/10986/42085 License: CC BY 3.0 IGO.”

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https://hdl.handle.net/10986/42085

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Human Development Perspectives

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12 days ago

Bruce Summers

Posted Cross-promoting - Advance UHC Newsletter - August 2024 / Vol. 7, No. 1 on Documents

Advance UHC Newsletter

August 2024 / Vol. 7, No. 1

The Advance Universal Health Coverage Multi-Donor Trust Fund

Increasing access to quality health and nutrition services for women and children in Cambodia

Recognizing that the first 1,000 days of life—from pregnancy to a child’s second birthday—establishes critical foundations for growth and development, the Cambodian government is improving the quality and capacity of local maternal and child health and nutrition services through the USD$62.5 million Cambodia Nutrition Project. The vital frontline tasks of the program is entrusted to the village health workers who help health centers provide outreach services to the most remote and hard-to-reach villages. They map out target households, monitor child growth, screen for malnutrition, communicate improved health and nutrition habits, and encourage use of an existing social protection scheme for greater access to essential health care. The health workers have an enlightened interest in seeing to the success of their labor—they are recruited from and live in the villages that they serve.

Advance UHC website

Welcome to the Advance UHC Newsletter

The Advance Universal Health Coverage Multi-Donor Trust Fund (Advance UHC) is a flagship partnership, initiated by the Australian Government’s Aid Program and the World Bank in 2015, supporting countries in the East Asia and Pacific region to equitably expand health services. Advance UHC has since attracted additional finance from partners including Gavi, the Global Fund, and the Bill & Melinda Gates Foundation.

Advance UHC funding enables targeted countries to:

• Produce analytics to identify strategic reforms and inform policy development.

• Implement health system strengthening initiatives, utilizing technical assistance where needed.

• Leverage increased health investments from development partners.

• Promote knowledge generation and exchange to share learnings.

We hope that you find the Advance UHC Newsletter to be a valuable and interesting source of information on ongoing fund activities. Subscribe and unsubscribe links are provided at the end of this newsletter. For other materials, publications, and reports, please visit our website through the link above. — Advance UHC communication team.

ADVANCE UHC IN FOCUS

Empowering Papua New Guinea’s frontline health workers towards UHC

In PNG’s East New Britain province, the World Bank and Advance UHC are supporting the provincial health authority to strengthen its primary health care system through improved data collection and communication between frontline health workers and decision-makers. Now, health workers are starting to receive greater supervision and support, and efforts are underway to prioritize budgets and policy improvements to the areas of greatest need.

Building on health and nutrition services in Lao PDR

The Lao Ministry of Health has launched Phase 2 of the Health and Nutrition Services Access Project (HANSA 2) which will build on the work of the first phase to improve access to quality health and nutrition services in remote rural areas of the country. Approved in February this year, HANSA 2 makes up to US$62 million of financing available to address longstanding problems in bringing health services to rural communities, particularly to women and children from ethnic groups. District health service staff will work with villagers to address poor diets and feeding practices among mothers, high birth rates among adolescents, and low take-up of services, including for ante-natal care, assisted child delivery, and vaccination. They will also expand services such as family planning, and water supply and sanitation.

East Asia and Pacific countries engage in post-pandemic healthcare reforms

COVID-19 showed how unprepared the world was for a pandemic and how much better prepared countries need to be to handle the next global health crisis. Having learned this lesson, countries in East Asia and the Pacific are ramping up post-pandemic health sector reforms across the region. The World Bank and its development partners, including Australia through the Advance UHC, are supporting these initiatives so that health coverage is expanded, the quality of primary health care improved, and core public health functions strengthened. The aim is to build human capital, protect lives and promote economic resilience in countries ranging from the Lao PDR to Samoa.

KNOWLEDGE TO ADVANCE UHC

Financing universal health coverage in Papua New Guinea

Senior Papua New Guinea officials were among the 150 delegates who explored the theme “Advancing universal health coverage in a post pandemic era” at the Asia Pacific Health Financing Forum held in Colombo, Sri Lanka, June 2024. COVID-19 brought elevated public debts against declining revenues to many countries and governments have to make tough decisions about how to best use their limited resources. The forum brought health and finance policymakers and practitioners together to find the most cost-effective and innovative options for improving the availability and quality of health services in their respective countries.

Tackling health and climate change in Tuvalu

The impacts of climate change are happening before the eyes of health officials in Tuvalu. Dengue fever and influenza outbreaks used to be rare in the island nation, but as the planet warms up such outbreaks have become frequent. Pelesala Kaleia told the Second Asia Pacific Health Financing Forum in Sri Lanka that there is an urgent need for climate smart health systems that can mitigate and adapt to the impacts of global warming. The Tuvalu health official was a featured speaker in a session exploring the intersecting challenges of advancing universal health coverage and climate change.

Shared learning for climate smart health systems

Building climate-smart healthcare systems that can address the impacts of climate change has become increasingly important as climate shocks continue to threaten health outcomes and slow progress toward universal health coverage. To meet this demand, a new Joint Learning Network Climate Smart Health Systems Collaborative was launched in February 2024. Representatives from 21 countries gathered in Washington DC to share their implementation experience and create knowledge that will further climate change adaptation, resilience, and mitigation in the health sector.

Highlighting Indonesia’s health system transformation

Indonesian policymakers shone the spotlight on how their country is transforming its health system through reforms that promote health equity and improve health outcomes during a side meeting of the Prince Mahidol Award Conference 2024 (PMAC) in Bangkok. Senior officials from the Ministry of Health, Ministry of Home Affairs, and National Health Insurance Agency (BPJS-K), briefed participants about the reforms the country has been undertaking to transform its health system and grapple persistent challenges. Advance UHC supports the analytics and technical assistance that have been contributing to Indonesia’s ongoing health system transformation agenda.

Using health claim data analysis to strengthen health systems

Keen to learn how to use existing insurance claim databases in their countries to make policies that effectively improve their health systems, over 50 delegates packed the room during the Prince Mahidol Award Conference 2024 (PMAC) in Bangkok. Supported by Advance UHC, the data driven decision making session was well-received with over capacity attendance. Large amounts of data, especially insurance claims for health service utilization, are routinely collected by health systems in many low-and middle-income countries. But the data is often buried in health system databases and is not always easy to collect and analyze. Participants of the workshop learned how to turn raw data into actionable information and use them to make policies that further UHC.

INCLUSION TO ADVANCE UHC

Papua New Guinea uses data to help frontline health workers improve access to services — video

East New Britain has been rolling out a successful supervisory checklist for health centers to collect information that can be used to improve service delivery. The Provincial Health Authority uses the data to identify problems, make decisions and supervise frontline workers in tackling them. One problem already identified is that disabled people cannot easily get into the health centers. Infrastructural changes will have to be made to accommodate them. With improved data collection and supervision, it is hoped that the standard of healthcare in rural communities will be lifted for all population groups.

See Video

Promoting disability inclusion in the health sector

In a concerted effort to promote disability inclusion in health sectors across East Asia and the Pacific, members of the World Bank’s health, and disability inclusion teams met with representatives from ASEAN Disability Forum, Pacific Disability Forum, and Australia’s Department of Foreign Affairs and Trade in Canberra for a one-day workshop.

PROFILE

A public health nurse rolling out a community-based program in Samoa

Falu Seiuli is a public health nurse working at Safotu District Hospital in Samoa. Falu is part of a team helping to roll out PEN Fa’a Samoa, a community-based program that promotes screening and treatment for conditions like hypertension, cardiovascular diseases, and diabetes. “We have found lots of people out in communities who need help but were not able to access the hospital for one reason or another," Falu says of her outreach work.

BRIEF NEWS

Improving public financial management in Papua New Guinea

Recognizing the critical role of sound financial management in improving the delivery of health services to provinces, Papua New Guinea’s (PNG) National Department of Health, Provincial Health Authorities, and the Department of Finance signed a Memorandum of Understanding (MOU) in July 2024 to improve health outcomes by enhancing financial planning, budgeting, accounting, reporting and auditing processes. Under the MOU, the Provincial Capacity Building Program in the Department of Finance will use their national and locally based provincial advisors to train and mentor Provincial Health Authority staff. The activities under the MOU will be implemented through the IMPACT Health project over the next six months and will be rolled out initially to four provinces—East New Britain, East Sepik, Chimbu and Central. Advance UHC funding provided technical assistance to develop the MOU through the World Bank’s PNG Health Programmatic Advisory Services and Analytics. The MOU represents one component of a comprehensive toolkit being introduced to better equip Provincial Health Authorities with the necessary tools, guidelines, and knowledge to effectively manage their financial systems, a critical aspect of further strengthening PNG’s health system.

Asia-Pacific health financing forum in Sri Lanka

In June 2024, the Health, Nutrition and Population teams for South Asia Region (SAR) and East Asia and the Pacific (EAP) brought together over 150 delegates from 20 countries in Colombo, Sri Lanka, for the second Asia-Pacific Health Financing Forum. With many nations embarking on health reforms to advance universal health coverage post COVID, the event provided a valuable opportunity for policy makers from both the ministries of health and finance to share knowledge and reflect on the best ways to address the demographic, economic, and disease transitions taking place across the region. A diverse range of themes were covered over the three-day event including climate and health financing, non-communicable disease financing, medicines as drivers of out-of-pocket spending, public financial management, health financing and aging, health taxes, workforce financing, and claims data analysis. The forum was organized in collaboration with key knowledge institutions from both regions and with support from vital health partners, the governments of Australia and Japan.

New projects move Lao PDR’s nutrition convergence program into phase 2

The Lao PDR’s nutrition convergence program to fight stunting in young children has moved into phase 2 with the launch of new projects in late 2023 and early 2024. These include the Reducing Rural Poverty and Malnutrition (II) project, the Health and Nutrition Services Access (HANSA 2) project, and the new Community Livelihood Enhancement and Resilience project. These are part of the multi-sector convergence approach to reducing malnutrition that sees the Lao government, the World Bank, and development partners working together to ensure nutrition and food security. The program does this through social assistance and livelihood options, improving childcare practices and access to health services, and providing clean water, sanitation, and hygiene. This multisectoral convergence approach has brought rapid improvements in child health and development in other countries. Some key results from phase 1 are available on the program webpage link above.

Assessing primary health care in the Pacific

Fiji’s Ministry of Health & Medical Services convened a high-level workshop in June 2024 aimed at transforming the country’s primary health care services. Opening the event, Fiji’s Minister of Health Ratu Atonio Rabici Lalabalavu said that a strengthened primary health care program would ensure that Fiji’s population receive the health care they need in a timely manner, fulfilling universal health coverage targets. The workshop drew on insights generated through the Primary Health Care Performance Initiative (PHCPI) which helped four Pacific countries—Fiji, Kiribati, Solomon Islands and the Marshall Islands–assess the state of their respective primary health care systems. As part of the assessment, all four countries conducted deep dives into gender and non-communicable diseases. Advance UCH funding contributed toward this effort which is an innovation for the PHCPI.

Shaping the future of health across Asia and the Pacific

Each year, the World Health Summit Regional Meeting takes place in a different part of the world, bringing local topics to the forefront of global discussions. Melbourne’s Monash University hosted this year's regional meeting in April under the theme ‘Shape the future of health across Asia and the Pacific’. The event was attended by a broad range of public health stakeholders including Saia Ma'u Piukala, the World Health Organization’s Regional Director for the Western Pacific, Atonio Rabici Lalabalavu, Minister of Health and Medical Services in Fiji, and Lucas de Toca, Australia’s Ambassador for Global Health. Advance UHC supported the attendance of Ajay Tandon, Lead Economist with the World Bank, who was a featured speaker in a session looking at improving health by strengthening healthcare financing, sharing insights into the progress of universal health coverage in Asia and the Pacific.

COUNTRY ACTIVITIES

May 2024: Timor-Leste’s Inter-Ministerial Task Force for Social Affairs (IMTSA) hosted a high-level workshop in Dili on May 2 to thrash out plans for tackling human capital problems in three key critical areas—early childhood development, food security and nutrition, and youth empowerment. Vice Prime Minister Mariano Sabino, the task force chairman, led cabinet ministers to work with heads of development partner organizations on strategic plans and initiatives to improve human capital outcomes in these areas. The discussions also include a consolidated national action plan, unified monitoring and evaluation framework, and sustainable financing. IMTSA was formed after the 2023 Timor-Leste Human Capital Review found that Timor-Leste is facing a human capital crisis—children born in the country today will be less than half as productive as adults if they don't enjoy complete education and full health growing up.

May 2024: Indonesia’s National Health Insurance Program (JKN) processes over nine million insurance claims each month. This large volume of data can be a powerful source of real-time information on the population’s health. To better utilize it, Indonesia’s Ministry of Health and the World Bank convened a 3-day course to train 50 Indonesian policy and data analysts to use this raw data to inform decision making and policy reforms that improve the quality and efficiency of JKN. The course on "Data Driven Decision Making for UHC: Leveraging Indonesia’s National Health Insurance Claims Data" was delivered in Bandung from May 21-23. Its content includes analysis of inpatient average length of stay, potentially preventable hospitalization, and readmission rates and fragmented utilization of outpatient care. Similar courses have already been successfully held in Vietnam and Thailand, but this was the first country specific offering using real claims data.

May 2024: Many of Samoa’s rural based health professionals gathered in Apia to reflect on the successes and challenges of implementing the country’s non-communicable disease action plan. The two-day workshop included doctors, nurses, nutritionists, health inspectors, midwives, and data management officers. The discussions ranged from the role of rural district hospitals in managing non-communicable diseases to how communities and schools could be more closely engaged in health promotion and screening efforts. The workshop was run by Samoa’s Ministry of Health with support from Samoa Health System Strengthening Project partners—the Australian government, the New Zealand government, and the World Bank.

March 2024: An assessment of the readiness of health facilities in the Lao PDR, titled Facility-Based Service Readiness Assessment in Four Northern Provinces of the Lao PDR, was published. The report discusses the findings of two assessments: a quality assessment in maternal and child health and the quality performance scorecard under the Health and Nutrition Services Access (HANSA) project. Four northern provinces, Phongsaly, Oudomxay, Huaphan, and Xieng Khuang, were selected as assessment sites because of their distinctive ethnic, cultural, and geographic characteristics. The provinces also lag behind other regions in terms of health outcomes and the nutritional status of mothers and children, and are the target areas of two current projects. This report identifies issues and gaps in current service availability and readiness, as well as universal health coverage.

Contacts: Somil Nagpal, snagpal@worldbank.org; Chadin Tephaval, ctephaval@worldbank.org; Jordie Kilby, jkilby@worldbankgroup.org

13 days ago

Bruce Summers

Posted Silver Opportunity Case Studies - Experiences with Building Integrated Services for Older Adults around Primary Health Care on Documents

June 2024, 154 pages.

English Edition, Paperback

ISBN: 978-1-4648-2014-4.

Price: $43.95 Staff: $35.50

Health care systems must be prepared to address the expanding and complex needs of an aging population. Rather than a “silver challenge,” this situation should be seen as an opportunity to reevaluate and reorganize the health care delivery system holistically.

Silver Opportunity Case Studies presents a comprehensive examination of care for older adults in diverse economic and geographic contexts through a collection of country and regional case studies. This collection of case studies complements the synthesis volume of global evidence—Silver Opportunity: Building Integrated Services for Older Adults around Primary Health Care—by offering practical insights for decision-making, sharing knowledge, and encouraging cross-learning. The book provides a deeper understanding of the complexities involved and highlights key issues and current practices at the country level. The overarching goal of the volume is to inform policy makers, health care professionals, and other stakeholders about effective practices for caring for older adults and to support the development of evidence-based policies that enhance their health and well-being.

Also read Silver Opportunity report.

Jul 03 2024, 2:31 PM