Advancement of global health: key messages from the Disease Control Priorities Project

Laxminarayan, Ramanan; Mills, Anne; Breman, Joel G.; Measham, Anthony R; Alleyne, George A.O.; Claeson, Mariam; Jha, Prabhat; Musgrove, Philip; Chow, Jeffrey; Shahid-Salles, Sonbol; Jamison, Dean T.

doi:10.1016/s0140-6736(06)68440-7

Cited by 279 publications

(204 citation statements)

References 6 publications

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“…23,24 Similarly, recent fi ndings of the Disease Control Priorities Project underline the costeffectiveness of quality primary healthcare -highly relevant given the pressures on national spending in the wake of the current global recession. 25,26 With greater recognition of the limitations and unintended consequences of vertical, unifocal disease-oriented programs, particularly in eroding or failing to develop the primary care infrastructure, the call for integrated health programming -in childhood and adult illness, chronic disease, maternal and reproductive health, HIV and tuberculosis care -is becoming clearer. Such integrated care systems, still warranting concerted research and development, will depend by defi nition on adequately functioning primary care delivery platforms.…”

Section: Health Systems and Access To Carementioning

confidence: 99%

Workforce Resources for Health in Developing Countries

Bangdiwala

Fonn

Okoye³

et al. 2010

Public Health Rev

111

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With increased globalization and interdependence among countries, sustained health worker migration and the complex threats of rapidly spreading infectious diseases, as well as changing lifestyles, a strong health workforce is essential. Building the human resources for health should not only include healthcare professionals like physicians and nurses, but must take into consideration community health workers, mid-level workers and strengthened primary healthcare systems to increase coverage and address the basic health needs of societies. This is especially true in low and middle-income countries where healthcare access is a critical challenge.There is a global crisis in the health workforce, expressed in acute shortages and maldistribution of health workers, geographically and professionally. This massive global shortage, though imprecise quantitatively, is estimated at more than 4 million workers. To respond to this crisis, policies and actions are needed to address the dynamics of the health labour market and the production and management of the health workforce, and to strengthen the performance of existing health systems. Schools of public health need to develop the range of capacity and leadership in addition to the traditional training of healthcare managers and researchers. Countries should fi rst identify their health problems in order to properly address their health worker needs, retention, recruitment and training, if they are to come close to reaching the Millennium Development Goals (MDGs) for health.

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Section: Health Systems and Access To Carementioning

confidence: 99%

Workforce Resources for Health in Developing Countries

Bangdiwala

Fonn

Okoye³

et al. 2010

Public Health Rev

111

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“…We do not suggest that mortality and disbursements should be perfectly correlated because the cost per year of life saved is not equal for all causes of mortality, with diff erences in cost-eff ectiveness of essential interventions. 22 Additionally, other dimensions to resource allocation are equally, if not more, important, than disease burden, and thus decisions should not solely focus on this measure. Justifi able, politically-guided deviations from even the best technical evidence in global health fi nance might exist.…”

Section: Assessment Of Global Health Fi Nancingmentioning

confidence: 99%

Misfinancing global health: a case for transparency in disbursements and decision making

2008

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To address the gap between health investments and fi nancial fl ows worldwide, we identifi ed the patterns in allocation of funds by the four largest donors-ie, the World Bank, Bill & Melinda Gates Foundation (BMGF), the US Government, and the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria-in 2005. We created a disbursement database with information gathered from the annual reports and budgets. Funding per death varied widely according to type of disease-eg, US$1029·10 for HIV/AIDS to $3·21 for non-communicable diseases. The World Bank, US Government, and Global Fund provided more than 98% of their funds to service delivery, whereas BMGF gave most of its funds to research. BMGF grants in 2005 were given largely to private research organisations, universities, and civil societies in rich countries, whereas the US Government and Global Fund primarily disbursed grants to sub-Saharan Africa. Publicly available data for global health disbursements is incomplete and not standardised. Continued attention is needed to develop country ownership, particularly in planning and priority setting.

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“…160 By contrast, the cost of scaling up to provide complete tetanus toxoid vaccination to unimmunised women of childbearing age on a widespread basis in south Asia and sub-Saharan Africa is $3·28-4·06 per woman, with an overall incremental cost per death averted of $271-394 ($14 per DALY averted). 161,162 As cost effective as tetanus toxoid campaigns are, in the absence of external funding to support the supplemental activities, the implementation of the high-risk approach was weak in the countries most in need. As a result, the 1995 target date for global elimination of neonatal tetanus was not met.…”

Section: Control: the Maternal And Neonatal Tetanus Elimination Initimentioning

confidence: 99%

Maternal and Neonatal Tetanus

Roper

Vandelaer

Gasse

2008

Obstetric Anesthesia Digest

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Maternal and neonatal tetanus are important causes of maternal and neonatal mortality, claiming about 180 000 lives worldwide every year, almost exclusively in developing countries. Although easily prevented by maternal immunisation with tetanus toxoid vaccine, and aseptic obstetric and postnatal umbilical-cord care practices, maternal and neonatal tetanus persist as public-health problems in 48 countries, mainly in Asia and Africa. Survival of tetanus patients has improved substantially for those treated in hospitals with modern intensive-care facilities; however, such facilities are often unavailable where the tetanus burden is highest. The Maternal and Neonatal Tetanus Elimination Initiative assists countries in which maternal and neonatal tetanus has not been eliminated to provide immunisation with tetanus toxoid to women of childbearing age. The ultimate goal of this initiative is the worldwide elimination of maternal and neonatal tetanus. Since tetanus spores cannot be removed from the environment, sustaining elimination will require improvements to presently inadequate immunisation and health-service infrastructures, and universal access to those services. The renewed worldwide commitment to the reduction of maternal and child mortality, if translated into effective action, could help to provide the systemic changes needed for long-term elimination of maternal and neonatal tetanus.Tetanus in the first 28 days of life (neonatal tetanus) was long recognised by clinicians in resource-poor settings as an important cause of neonatal death. However, since babies affected by this disease usually are born at home and die there without registration of either event, the true burden was unknown. In the 1970s and 1980s, community-based surveys about neonatal tetanus from more than 40 countries showed that fewer than 10% of tetanus-related cases and deaths were routinely reported in most countries: in some regions, the reporting fraction was as low as 2-5%. 1,2 Estimates based on the results of these surveys, and tetanus data routinely reported to WHO suggested that, in the 1980s, more than 1 million deaths every year were attributable to tetanus, with an estimated 787 000 deaths in 1988 from neonatal tetanus alone. 1,3 In 1989, the worldwide public-health community made a commitment to the elimination of neonatal tetanus (defined as fewer than one case of neonatal tetanus per 1000 livebirths in all districts) by 1995. 3,4 Maternal tetanus is defined as tetanus during pregnancy, or within 6 weeks of the end of pregnancy (whether pregnancy ended with birth, miscarriage, or abortion), and has the same risk factors and means of prevention as neonatal tetanus. In the early 1990s it was estimated to account for about 5% of maternal mortality, or 15 000-30 000 deaths every year. 5,6 In 1999, the elimination of maternal tetanus was added to the goals of the elimination programme for neonatal tetanus, and the initiative was renamed the Maternal and Neonatal Tetanus Elimination Program. 6 Good progress has been made in the 15 ...

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Advancement of global health: key messages from the Disease Control Priorities Project

Cited by 279 publications

References 6 publications

Workforce Resources for Health in Developing Countries

Workforce Resources for Health in Developing Countries

Misfinancing global health: a case for transparency in disbursements and decision making

Maternal and Neonatal Tetanus

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