Wednesday, October 31, 2007

[EQ] Conditional Cash Transfers for Improving Uptake of Health Interventions - A Systematic Review

Conditional Cash Transfers for Improving Uptake of Health Interventions in Low- and Middle-Income Countries

A Systematic Review

 

Mylene Lagarde, Andy Haines, Natasha Palmer, London School of Hygiene & Tropical Medicine, London, England

JAMA Vol. 298 No. 16, October 24/31, 2007

 

Available online at: http://jama.ama-assn.org/cgi/content/full/298/16/1900

Context  Cash transfers conditional on certain behaviors, intended to provide access to social services, have been introduced in several developing countries. The effectiveness of these strategies in different contexts has not previously been the subject of a systematic review.

Objective  To assess the effectiveness of conditional monetary transfers in improving access to and use of health services, as well as improving health outcomes, in low- and middle-income countries.

Data Sources  Relevant publications were identified via electronic medical and social science databases from inception to April 2006 (PubMED, EMBASE, POPLINE, CAB Direct, Healthcare Management Information Consortium, WHOLIS (World Health Organization Library Database), African Healthline, International Bibliography of the Social Sciences (IBSS), Eldis, British Library for Development Studies (BLDS), ID21, Journal Storage (Jstor), Inter-Science, ScienceDirect, Internet Documents in Economics Access Service (Research Papers in Economics) (IDEAS[Repec]), Latin American and Caribbean Health Sciences Literature (LILACS), MEDCARIB, Virtual Library in Health (ADOLEC), Pan American Health Organization (PAHO), FRANCIS, The Cochrane Central Register of Controlled Trials, the Database of Abstracts of Reviews of Effectiveness, and the Effective Practice and Organization of Care Group (EPOC) Register. Reference lists of relevant papers and "gray" literature resources were also searched.

Study Selection  To be included, a paper had to meet study design criteria (randomized controlled trial, interrupted time series analysis, and controlled before and after study) and include a measure of at least 1 of the following outcomes: health care utilization, health expenditure, or health outcomes. Twenty-eight papers were retrieved for assessment and 10 were included in this review.

Data Extraction  Methodological details and outcomes were extracted by 2 reviewers who independently assessed the quality of the papers.

Results  Overall, the evidence suggests that conditional cash transfer programs are effective in increasing the use of preventive services and sometimes improving health status.

Conclusions  Further research is needed to clarify the cost effectiveness of conditional cash transfer programs and better understand which components play a critical role. The potential success and desirability of such programs in low-income settings, with more limited health system capacity, also deserves more investigation

Related Paper:

Bridging the Coverage Gap in Global Health
Eiss and Glass, Fogarty International Center, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
JAMA 2007;298:1940-1942. at: http://jama.ama-assn.org/cgi/content/full/298/16/1940

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area] 

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
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[EQ] Pharmacy Health Literacy Assessment Tool User's Guide - Training Program for Pharmacy Staff

 

Is Our Pharmacy Meeting Patients' Needs?

Pharmacy Health Literacy Assessment Tool User's Guide

 

U.S. Department of Health and Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ)
The Robert Wood Johnson Foundation provided funding for this guide, 2007

 

Website: http://www.ahrq.gov/news/press/pr2007/pharmtoolpr.htm

This pharmacy health literacy tool was designed to capture perspectives of three critical audiences-objective auditors, pharmacy staff, and patients. The three parts of the assessment are complementary and designed to form a comprehensive assessment. Although the assessment was designed to be used in outpatient pharmacies of large, urban, public hospitals that primarily serve a minority population, it can be adapted for use in other pharmacy and non-pharmacy environments.

To download print version (PDF File, 1.3 MB).

By Jacobson KL, Gazmararian JA, Kripalani S, et al.

Contents

Introduction
Part I: Assessment Tour of the Pharmacy
Part II: Survey of Pharmacy Staff
Part III: Pharmacy Patient Focus Groups
Part IV: Using Assessment Results
References
Appendixes
Appendix 1: Conducting a Health Literacy Assessment—Flow Chart
Appendix 2: Health Literacy Assessment Tour Guide
Appendix 3: Health Literacy Assessment Survey of Pharmacy Staff
Appendix 4: Samples Tables and Analyses for Pharmacy Staff Survey
Appendix 5: Health Literacy Assessment Facilitator's Guide for Patient Focus Groups
Appendix 6: Sample Outline for Report of Focus Group Results

 

Strategies To Improve Communication Between Pharmacy Staff and Patients

Training Program for Pharmacy Staff

Curriculum Guide

 

This training program is designed to introduce pharmacists to the problem of low health literacy in patient populations and to identify the implications of this problem for the delivery of health care services. The program also explains techniques that pharmacy staff members can use to improve communication with patients who may have limited health literacy skills.

Select to download print version (PDF File, 240 KB).

 

By Sunil Kripalani, M.D., M.Sc., and Kara L. Jacobson, M.P.H, CHES.


Contents

Overview of the Training Program
     Suggested Audience
     Materials Provided
     Format of Program
     Suggested Agenda
Slide Set and Notes for the Trainer
References

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area] 

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
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[EQ] Global Course: Accelerating Progress Towards the Health Millennium Development Goals (MDGs) and other Health Outcomes

Global Course: Accelerating Progress Towards the Health Millennium Development Goals (MDGs) and other Health Outcomes

 

World Bank Institute Human Development (WBIHD) Health and AIDS

 

Dates:    March 24 - April 4, 2008 Location: Washington, D.C

Application Deadline: February 22, 2008

 

“….Money counts for better health! However, more money and even rapid economic growth are not enough to achieve desirable Health Outcomes and the Millennium Development Goals (MDGs). Systems structure and efficiency matter, as do supporting institutions, households and communities, policies and politics. While there is long-standing recognition that health outcomes are significantly determined at the household level and are greatly affected by factors outside the health sector such as water and sanitation and transport infrastructure, policies continue mainly to focus on supply production factors within the health sector.

 

This new program approaches health outcomes from the demand side through a multisectoral perspective, looking into mechanisms such as Poverty

Reduction Strategy Papers (PRSPs), and Sector Wide Approaches (SWAPs) The course underscores the different roles necessary at each different sector

for a multisectoral approach, the need for coordination at the central level, and also alignment of donors with national processes - especially

budgets - to ensure harmonization.

 

This course will build capacity for developing multisectoral health outcome strategies, emphasizing that better effective interventions, actions and policies exist and that adaptation to the country situation is critical….”

 

 

Course Objectives

 

The course will share information, tools and knowledge of reforms and essential public health functions in order to empower participants to

become effective agents of change. Specific learning objectives include:

 - Learning to apply a multisectoral framework to better achieve health, nutrition, and population outcomes

 - Understanding the role of the public sector, and the impact of health systems performance on the MDGs

 - Using health sector reform to achieve health outcomes

 - Learning how to apply diagnostic, planning and implementation support tools

 

Target Audience: Government officials and private sector practitioners involved health outcomes related policy making and programs and project design and implementation. Country teams encouraged.

 

Registration:

 

Please go to the online application form at

http://info.worldbank.org/etools/wbi_learning/sec/form_e.cfm?sch_id=HNP07-01-123

 

 

Should you have any questions, please contact:

 

Michelle Morris (Administrative) - World Bank Institute - Health and AIDS program

1818 H St. NW, Mail Stop# J 3-302 - Washington DC 20433

Tel. 1-202-473-7285 Fax: 1-202-522-0638 Email: mmorris1@worldbank.org

Isabel Rocha Pimenta (Email:irochapimenta@worldbank.org) (Content), and Gaston Sorgho (Email: gsorgho@worldbank.org)  (Content)

 

(See attached file: wb mdg brochure 10-15-07.pdf)

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area] 

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.

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Tuesday, October 30, 2007

[EQ] Registering births and deaths :The Job that No One Wants - The Lancet Series: WHO Counts?

Registering births and deaths : The Job that No One Wants

 

29 OCTOBER 2007 - BEIJING/GENEVA -- The Health Metrics Network launches a drive today to encourage countries to count all births and deaths through civil registration.

 

The Health Metrics Network is a global partnership – hosted by the World Health Organization (WHO) – established to address the lack of reliable health information in developing countries.

 

Website: http://www.who.int/healthmetrics/en/

 

As part of this drive, the Health Metrics Network is releasing a Monitoring vital events resource kit CD-ROM.
This kit contains the tools and reference texts that countries can use to guide them in their work towards full civil registration.

Website: http://www.who.int/healthmetrics/tools/logbook/en/move/web/index.html

 

 

“…..Civil registration is the way by which countries keep track of births, deaths and marital status of their people. These systems are the best way to produce vital statistics – counts of births and deaths and causes of death. Such statistics are needed to show whether health programmes are working. They are also essential to assess whether development aid is well spent.

 

The lack of civil registration systems means that every year, almost 40% (48 million) of 128 million global births go unregistered. The situation is even worse for death registration. Globally, two-thirds (38 million) of 57 million annual deaths are not registered. WHO receives reliable cause-of-death statistics from only 31 of its 193 Member States.

 

The absence of civil registration has other implications. When children's births are not registered they are less likely to benefit from basic human rights – social, political, civic or economic.

 

At the other end of the lifespan, when deaths go uncounted and causes of death are not documented, governments are unable to design effective health policies, measure their impact or know whether health budgets are being well-spent.

 

"No single UN agency is responsible for ensuring that births and deaths are registered, so it has fallen between the cracks. That is why we have failed to establish, support, and sustain civil registration systems over the past 30 years in the developing world," WHO Director-General Dr Margaret Chan said today at the Global Forum for Health Research in Beijing…..”

 

For further information, please contact:

Carla Abouzahr, Deputy Executive Secretary, Health Metrics Network, E-mail: abouzahrc@who.int
Professsor Alan Lopez, Head, School of Population Health, University of Queensland, E-mail: a.lopez@sph.uq.edu.au
Professor Kenneth Hill, Associate Director, Harvard Centre for Population and Development Studies, E-mail: kenneth_hill@harvard.edu
Dr Prasanta Mahapatra, Director, Institute of Health Systems, Hyderabad, Mobile: +91 984 878 2039, Email: pmahapat@gmail.com
Dr Laragh Gollogly, Editor, WHO Press, Mobile: +41 22 791 1968, E-mail: golloglyl@who.int

 

 

 

The Lancet: Who Counts? Series at: http://www.thelancet.com/online/focus/who-counts/collection

Who Counts? - A test of our humanity
In the Comment which opens the Series, The Lancet's editor Dr Richard Horton says: "This 'scandal of invisibility' means that millions of human beings are born and die without leaving any record of their existence. Over three-quarters of them are to be found in sub-Saharan Africa and South-East Asia." With the Who Counts? team urging donors and global partners to do more to promote and support civil registration systems, Dr Horton concludes: "Ultimately, this campaign is about how much each of us values the life of every other human being. It is a test of our humanity."

A scandal of invisibility: making everyone count by counting everyone
Most people in Africa and Asia are born and die without leaving a trace in any legal record or statistic, a situation which has arisen due to the stagnation of civil registration systems in many poor countries. Authors of the first article look at how vital statistics are crucial for effective health policy and the rights that civil registration confers on individuals. Dangers of civil registration are also explored. The authors conclude: "The continued cost of ignorance borne by countries without civil registration far outweighs the affordable necessity of action."

Vital statistics: not vital enough
The need for reliable national statistics for births, deaths, and causes of death has never been greater - but countries and developmental partners have not recognised this as a priority. Authors of the second paper look at inconsistency the lack of data from sub-Saharan Africa and the inconsistency in data from developed countries. They conclude: "It is unacceptable for us to be as ignorant about the state of a nation's health in 50 years time as we are today."

Interim measures to obtain vital data for developing countries
Most developing countries do not have fully functional civil registration systems (FFCRS). They have instead had to use interim measures to obtain vital data. These methods, though effective in the short term, should not be regarded as substitutes for complete civil registration, and international organisations, governments and academia all have responsibilities to ensure that civil registration systems are improved. The authors of the third paper conclude that international agencies should maintain their support for coordinated data collection and sharing activities and for specialised training, while increasing efforts to achieve a FFCRS.

The way forward for vital statistics
There is no single blueprint for establishing and maintaining systems for gathering sound statistics on births, deaths, and causes of death, as each country has its own unique set of challenges. But whatever the individual country's situation, there are steps that can be taken. The authors of the final paper propose three options, which are not mutually exclusive, to tackle the challenge of establishing civil registration systems and obtaining and maintaining vital statistics.

Countries need to invest long-term in civil registration
Civil registration is a long-term investment, and countries first need to get the right legislation in place, making it a requirement to register births and deaths. This Comment which accompanies the Who Counts? Series concludes that the health sector is best placed to promote the benefits of civil registration for all sectors of society, and to lead intersectoral collaboration in establishing routine mechanisms for gathering population and health data. These measures permit the health sector to function, and provide evidence for evaluating global efforts to accelerate health development ..”

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area] 

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.

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    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.