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If children are to be protected from HIV, the expansion of PMTCT programs must be complemented by increased provision of paediatric treatment. This is expensive, yet there are humanitarian, equity and children's rights arguments to justify the prioritization of treating HIV-infected children. In the context of limited budgets, inefficiencies cost lives, either through lower coverage or less effective services. With the goal of informing the design and expansion of efficient paediatric treatment programs able to utilize to greatest effect the available resources allocated to the treatment of HIV-infected children, this article reviews what is known about cost drivers in paediatric HIV interventions, and makes suggestions for improving efficiency in paediatric HIV programming. High-impact interventions known to deliver disproportional returns on investment are highlighted and targeted for immediate scale-up. Progress will carry a cost - increased funding, as well as additional data on intervention costs and outcomes, will be required if universal access of HIV-infected children to treatment is to be achieved and sustained.

Achievement of Millennium Development Goal (MDG) 4 for child survival requires acceleration of gains in newborn survival, and current trends in improving maternal health will also fall short of reaching MDG 5 without more strategic actions. We present a Maternal Newborn and Child Health (MNCH) strategy for accelerating progress on MDGs 4 and 5, sustaining the gains beyond 2015, and further bringing down maternal and child mortality by two thirds by 2030. The strategy takes into account current trends in coverage and cause-specific mortality, builds on lessons learned about what works in large-scale implementation programs, and charts a course to reach those who do not yet access services. A central hypothesis of this strategy is that enhancing interactions between frontline workers and mothers and families is critical for increasing the effective coverage of life-saving interventions. We describe a framework for measuring and evaluating progress which enables continuous course correction and improvement in program performance and impact. Evidence for the hypothesis and impact of this strategy is being gathered and will be synthesized and disseminated in order to advance global learning and to maximise the potential to improve maternal and neonatal survival.

This United States Agency for International Development discussion paper seeks to provide background on some of the recent contributions to the policy literature on extreme poverty. It does not represent the official policy or position of USAID but is meant to spark and inform dialogue on important development issues, both within the Agency and with our external partners.

Ensuring that medicines which achieve important health outcomes are available, accessible to all, used appropriately, and sustainably affordable is essential for realizing universal health coverage. Stakeholder cooperation and use of information and financing system levers provide opportunities to work toward this goal.

For more than 40 years, Management Sciences for Health (MSH) has been working around the world to bridge the gap between what is known about public health and what is actually practiced. We believe that strengthening health systems is the most sustainable way of improving health and saving lives.

For over 40 years, Management Sciences for Health (MSH) has been working in partnership with nongovernmental organizations (NGOs) around the world to support the delivery of community-based health services to underserved populations.As NGOs and civil society become more prominent in the delivery of health care and related services, such as advocacy and health education, local organizations have gr

Leadership and Management Skills Help Gotani Health Center Improve Maternal and Child Health Outcomes

As national antiretroviral treatment (ART) programmes scale up, it is essential that information is complete, timely and accurate for site monitoring and national planning. This study assessed the quality of quarterly aggregate summary data for April to June 2006 compiled and reported by ART facilities as compared to the "gold standard" facility summary data compiled independently by the Ministry of Health supervision team. The national summary using the site reports resulted in a 12% undercount in the national total number of persons on first-line treatment. While many sites are able to generate complete data summaries, the accuracy of facility reports is not yet adequate for national monitoring. The Ministry of Health and its partners should continue to identify and support interventions such as supportive supervision to build sites' capacity to maintain and compile quality data to ensure that accurate information is available for site monitoring and national planning.

Approximately 1 million people are infected with HIV in Malawi, where AIDS is the leading cause of death in adults. By December 31, 2007, more than 141,000 patients were initiated on antiretroviral treatment (ART) by use of a public health approach to scale up HIV services. In Malawi, a public health approach to ART increased treatment access and maintained high 6- and 12-month survival. Resource-limited countries scaling up ART programs may benefit from this approach of simplified clinical decision making, standardized ART regimens, nonphysician care, limited laboratory support, and centralized monitoring and evaluation.

The global demand for artemisinin-based combination therapy (ACT) has grown sharply since its recommendation by the World Health Organization in 2002. However, a combination of financing and programmatic uncertainties, limited suppliers of finished products, information opacity across the different tiers in the supply chain, and widespread fluctuations in raw material prices have together contributed to a market fraught with demand and supply uncertainties and price volatility. Various short-term solutions have been deployed to alleviate supply shortages caused by these challenges; however, new mechanisms are required to build resilience into the supply chain. This review concludes that a mix of strategies is required to stabilize the artemisinin and ACT market. First, better and more effective pooling of demand and supply risks and better contracting to allow risk sharing among the stakeholders are needed. Physical and financial buffer stocks will enable better matching of demand and supply in the short and medium term. Secondly, physical buffers will allow stable supplies when there are procurement and supply management challenges while financial buffer funds will address issues around funding disruptions. Finally, in the medium to long term, significant investments in country level system strengthening will be required to minimize national level demand uncertainties. In addition a voluntary standard for extractors to ensure appropriate purchasing and sales practices as well as minimum quality and ethical standards could help stabilize the artemisinin market in the long term.

This article assessed private sector accredited drug dispensing outlets in Morogoro and pharmacies in Dar es Salaam, Tanzania, to determine (1) the level of knowledge about tuberculosis (TB) among dispensers in Tanzania's retail pharmaceutical sector; (2) practices related to identification of patients with suspected TB; (3) the availability of educational materials and training; and (4) the availability of first- and second-line anti-tuberculosis treatment in retail drug outlets. Private retail drug outlets are convenient; most are open at least 12 h per day, 7 days/week. Although 95% of dispensers identified persistent cough as a symptom of TB, only 1% had received TB-related training in the previous 3 years; 8% of outlets stocked first-line anti-tuberculosis medicines, which are legally prohibited from being sold at retail outlets. The majority of respondents reported seeing clients with TB-like symptoms, and of these 95% reported frequently referring clients to nearby health facilities. Private retail pharmaceutical outlets can potentially contribute to TB case detection and treatment; however, a coordinated effort is needed to train dispensers and implement appropriate referral procedures.

Health Must Remain a Top Priority We believe the Post-2015 Development Agenda must accelerate progress on unmet MDGs and create a tangible, bold vision for achieving future health progress. It should have a strong emphasis on country ownership and empowering locals to take greater control over their own development. 

In most low-income countries, when people are sick enough to seek treatment, their first stop is usually a drug seller— an unlicensed drug seller. Too often, the medicine they receive is poor quality or costly—or even the wrong drug altogether. They stay sick, or worse, die from receiving the wrong drug. It doesn't have to be that way.

Management Sciences for Health serves on the steering group of The NCD Alliance, which has issued this polcy brief on universal health coverage and non-communicable diseases. 

Some countries have made great strides in expanding Tuberculosis (TB) control over the last few years, with significant assistance from donors, such as the Global Fund (GF) for Acquired Immune Deficiency Syndrome (AIDS), TB and Malaria. While there is still substantial donor funding for TB programs, these funds are expected to diminish in countries that have improving economies.

Indonesia has made great strides in expanding Tuberculosis (TB) control over the last few years, with significant assistance from donors, such as the Global Fund against Acquired Immune Deficiency Syndrome (AIDS), TB and Malaria (GFATM) and the United States Agency for International Development (USAID).

Understanding the economic burden to society from a disease like TB is important as it can be used as evidence when advocating for greater investment. This report describes the development of a tool to estimate the economic burden of TB in Indonesia and the results stemming from its use.

This report describes recommended actions for the National Tuberculosis Control Program (NTP) to consider in developing its Exit Strategy implementation plan. It also describes a set of recommended technical assistance and training activities aimed at supporting the NTP in this process.

In many countries tuberculosis (TB) control programs are scaling-up the detection and treatment of TB cases to reduce the burden on patients, their families and society. This will result in significantly increased costs over the next few years until prevalence begins to fall.

The Rwandan Ministry of Health, in collaboration with the USAID-funded Integrated Health Systems Strengthening Project (IHSSP), carried out a study to determine the costs of providing hospital services. The results of the costing were intended for use in re-designing insurance reimbursement mechanisms and levels.

Ethiopia has a high prevalence of tuberculosis (TB) and is one of the 22 highest TB burden countries in the world. It is also one of the countries where many people who develop TB every year do not get treated. One of the reasons why infected people delay or do not seek diagnosis and treatment is economic access – the cost to patients and their families.

The purpose of this study was to develop estimates of the cost of the scaled-up scorecard interventions. Based on the action plans developed by the programmes, the interventions would require resources costing $79.9 million from 2007 through 2010 to achieve the targeted coverage levels.

The primary objective of this study was to model the costs and funding requirements of the Ministry of Health’s Minimum Package of Activities (MPA), which covers services provided by health centers.

Year Ended June 30, 2013, drawn from audited financial statements.

The vision of universal health coverage (UHC) is that everyone has access to the quality prevention and treatment services they need, without enduring financial hardship as a result of essential health expenditures. UHC programmes pursue this aim by mobilising all viable financial resources, with an emphasis on increasing public funding; by using these resources to strengthen health systems and ensure service quality; and by establishing financial protection mechanisms.

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