Mapping the extent to which performance-based financing (PBF) programs reflect quality, informed choice and voluntarism and implications for family planning services: A review of indicators

Expanding access to and use of voluntary family planning (FP) services is a well-established global health goal–it is a specific target under the Sustainable Development Goal (SDG) of good health and well-being, an integral component of Every Woman Every Child (EWEC), and the overall objective of the Family Planning 2020 (FP2020) partnership, among other initiatives. | One promising approach for achieving global voluntary FP goals is performance-based financing (PBF), which deploys financial incentives to the health system to improve service availability, utilization, and quality as well as addressing some public financial management bottlenecks by directly targeting resources to facilities based on performance. | Setting global voluntary FP goals implies following a rights-based approach to family planning, which uses a set of standards and principles to guide program assessment, planning, implementation, monitoring, and evaluation that enables individuals and couples to decide freely and responsibly the number and spacing of their children, to have the information and services to do so, and to be treated equitably and free of discrimination. | While both PBF, which uses financial disbursements to incentivize health service delivery and quality, and rights-based programming have informed efforts to strengthen and scale FP services, there are gaps in understanding the linkages between PBF and a rights-based approach (RBA) to FP services. To address this gap, a review of PBF operations manuals was undertaken together with an analysis of PBF indicators relevant to FP services. This and another report (Mapping the extent to which performance-based financing (PBF) programs reflect quality, informed choice, and voluntarism and implications for family planning services: A review of PBF operational manuals) assess whether existing FP indicators are sensitive to the principles associated with an RBA

Mapping the extent to which performance-based financing (PBF) programs reflect quality, informed choice, and voluntarism and implications for family planning services: A review of PBF operational manuals

Expanding access to and use of voluntary family planning (FP) services is a well-established global health goal- it is a specific target under the Sustainable Development Goal (SDG) of good health and well-being, an integral component of Every Woman Every Child (EWEC), and the overall objective of the Family Planning 2020 (FP2020) partnership, among other initiatives. | One promising approach for achieving global voluntary FP goals is performance-based financing (PBF), which deploys financial incentives to the health system to improve service availability, utilization, and quality as well as addressing some public financial management bottlenecks by directly targeting resources to facilities based on performance. | Setting global voluntary FP goals implies following a rights-based approach to family planning, which uses a set of standards and principles to guide program assessment, planning, implementation, monitoring, and evaluation that enables individuals and couples to decide freely and responsibly the number and spacing of their children, to have the information and services to do so, and to be treated equitably and free of discrimination. | While both PBF, which uses financial disbursements to incentivize health service delivery and quality, and rights-based programming have informed efforts to strengthen and scale FP services, there are gaps in understanding the linkages between PBF and a rights-based approach (RBA) to FP services. To address this gap, a review of performance-based financing (PBF) operations manuals was undertaken together with an analysis of PBF indicators relevant to FP services. This and another report (Mapping the extent to which performance-based financing (PBF) programs reflect quality, informed choice and voluntarism and implications for family planning services: A review of indicators) assess whether existing FP indicators are sensitive to the principles associated with an RBA

The extent to which performance-based financing programs\u27 operations manuals reflect rights-based principles: Implications for family planning services

Recognition is growing that development programs need to be guided by rights as well as to promote, protect, and fulfill them. Drawing from a content analysis of performance-based financing (PBF) implementation manuals, we quantify the extent to which these manuals use a rights perspective to frame family planning services. PBF is an adaptable service purchasing strategy that aims to improve equity and quality of health service provision. PBF can contribute toward achieving global family planning goals and has institutional support from multiple development partners including the Global Financing Facility in support of Every Woman Every Child. A review of 23 PBF implementation manuals finds that all documents are focused largely on the implementation of quality and accountability mechanisms, but few address issues of accessibility, availability, informed choice, acceptability, and/or nondiscrimination and equity. Notably, operational inclusion of agency, autonomy, empowerment, and/or voluntarism of health care clients is absent. Based on these findings, we argue that current PBF programs incorporate some mention of rights but are not systematically aligned with a rights-based approach. If PBF programs better reflected the importance of client-centered, rights-based programming, program performance could be improved and risk of infringing rights could be reduced. Given the mixed evidence for PBF benefits and the risk of perverse incentives in earlier PBF programs that were not aligned with rights-based approaches, we argue that greater attention to the rights principles of acceptability, accessibility, availability, and quality; accountability; agency and empowerment; equity and nondiscrimination; informed choice and decision making; participation; and privacy and confidentiality would improve health service delivery and health system performance for all stakeholders with clients at the center. Based on this review, we recommend making the rights-based approach explicit in PBF; progressively operationalizing rights, drawing from local experience; validating rights-based metrics to address measurement gaps; and recognizing the economic value of aligning PBF with rights principles. Such recommendations anchor an aspirational rights agenda with a practical PBF strategy on the need and opportunity for validated metrics

Aperçu de la pathologie animale en région Pacifique Sud. Applications à la Nouvelle-Calédonie

Energy absorption capability of structures with embedded pores depends upon the amount of voids present and their configurations/distributions. In this study, the energy absorption of acrylonitrile butadiene styrene (ABS) and polylactic acid (PLA) structures with varying pore shapes and sizes are investigated. The research was performed by two teams comprised of High School/Middle School teachers and undergraduate students as part of National Science Foundation (NSF) sponsored Research Experience for Teacher (RET)/Research Experience for Undergraduates (REU) teams. ABS samples were fabricated by Team 1 and utilized cubic unit cells with octahedral pores while Team 2 fabricated PLA samples that utilized unit cells with spherical pores. Eight sets of samples with dimensions 25mm × 25mm × 20mm were fabricated using a Makerbot Replicator 2X for ABS samples and a Lulzbot TAZ 5 for PLA samples. Each sample incorporated a 5 × 5 × 4 array of pores. All the samples were tested in compression and energy absorption per unit material volume of all the samples up to a particular maximum load was calculated from load-deflection curves. It is observed that the specific energy absorption of PLA and ABS porous structures greatly increases with increased porosity. Copyright © 2017 by ASM

The NSF REU/RET Research on Energy Absorbing 3D Printed Polymer Structures

Energy absorption capability of structures with embedded pores depends upon the amount of voids present and their configurations/distributions. In this study, the energy absorption of acrylonitrile butadiene styrene (ABS) and polylactic acid (PLA) structures with varying pore shapes and sizes are investigated. The research was performed by two teams comprised of High School/Middle School teachers and undergraduate students as part of National Science Foundation (NSF) sponsored Research Experience for Teacher (RET)/Research Experience for Undergraduates (REU) teams. ABS samples were fabricated by Team 1 and utilized cubic unit cells with octahedral pores while Team 2 fabricated PLA samples that utilized unit cells with spherical pores. Eight sets of samples with dimensions 25mm × 25mm × 20mm were fabricated using a Makerbot Replicator 2X for ABS samples and a Lulzbot TAZ 5 for PLA samples. Each sample incorporated a 5 × 5 × 4 array of pores. All the samples were tested in compression and energy absorption per unit material volume of all the samples up to a particular maximum load was calculated from load-deflection curves. It is observed that the specific energy absorption of PLA and ABS porous structures greatly increases with increased porosity. Copyright © 2017 by ASM

Computational and Experimental Analysis of the Interactions Between C3 and Compstatin Family Peptides

We present the physicochemical basis of binding for several active peptides from the compstatin family against the immune system protein C3. The peptide sequences are tailored to promote enhancement of the structural and physicochemical properties that contribute to binding, including consideration of the dynamic character of the protein/ligand system. The peptide sequences are designed using: (i) computational sequence selection and approximate binding affinity calculations, (ii) molecular dynamics simulations, and (iii) rational optimization [1–3]. A subset of the new peptides has been tested in ELISA inhibition assays using human serum, and produced comparable IC50 values to those of known peptides. The most promising new designs acquire an advantage in that they combine a more optimal balance between hydrophobicity, which is important for binding, and polarity, which is important for solubility, compared to the most potent known peptides. Thus, the new peptides are good candidates to become therapeutics, upon further optimization. Given the species specificity of known compstatin family peptides for primate but not for non-primate mammals, some of the new designs aim at binding to both human and rat C3. The dual specificity design was conducted using molecular dynamics simulations based on our recent atomic detail model for compstatin-human/rat binding [3]; however, the efficacy of the new peptides for rat C3 binding and inhibition remains to be seen in experimental assays using rat serum

Novel compstatin family peptides inhibit complement activation by drusen-like deposits in human retinal pigmented epithelial cell cultures.

We have used a novel human retinal pigmented epithelial (RPE) cell-based model that mimics drusen biogenesis and the pathobiology of age-related macular degeneration to evaluate the efficacy of newly designed peptide inhibitors of the complement system. The peptides belong to the compstatin family and, compared to existing compstatin analogs, have been optimized to promote binding to their target, complement protein C3, and to enhance solubility by improving their polarity/hydrophobicity ratios. Based on analysis of molecular dynamics simulation data of peptide-C3 complexes, novel binding features were designed by introducing intermolecular salt bridge-forming arginines at the N-terminus and at position -1 of N-terminal dipeptide extensions. Our study demonstrates that the RPE cell assay has discriminatory capability for measuring the efficacy and potency of inhibitory peptides in a macular disease environment

Novel compstatin family peptides inhibit complement activation by drusen-like deposits in human retinal pigmented epithelial cell cultures

We have used a novel human retinal pigmented epithelial (RPE) cell-based model that mimics drusen biogenesis and the pathobiology of age-related macular degeneration to evaluate the efficacy of newly designed peptide inhibitors of the complement system. The peptides belong to the compstatin family and, compared to existing compstatin analogs, have been optimized to promote binding to their target, complement protein C3, and to enhance solubility by improving their polarity/hydrophobicity ratios. Based on analysis of molecular dynamics simulation data of peptide–C3 complexes, novel binding features were designed by introducing intermolecular salt bridge-forming arginines at the N-terminus and at position −1 of N-terminal dipeptide extensions. Our study demonstrates that the RPE cell assay has discriminatory capability for measuring the efficacy and potency of inhibitory peptides in a macular disease environment