Assessing the use of an essential health package in a sector wide approach in Malawi

<p>Abstract</p> <p>Background</p> <p>The sector wide approach (SWAp) used in many developing countries is difficult to assess. One way is to consider the essential health package (EHP) which is commonly the vehicle for a SWAp's policies and plans. It is not possible to measure the impact of an EHP by measuring health outcomes in countries such as Malawi. But it is possible to assess the choice of interventions and their delivery in terms of coverage. This paper describes an attempt to assess the Malawi SWAp through its EHP using these available measures of technical efficiency.</p> <p>Methods</p> <p>A burden of disease model was used to identify the priority diseases and their estimated incidence. Data from the health management information system (HMIS) were used to measure the coverage of these interventions. A review of the cost-effectiveness of the chosen and potential interventions was undertaken to assess the appropriateness of each intervention used in the EHP. Expenditure data were used to assess the level of funding of the EHP.</p> <p>Results</p> <p>33 of the 55 EHP interventions were found to be potentially cost-effective (<$150/DALY), 12 were not so cost-effective (>$150/DALY) and cost-effective estimates were not available for ten. 15 potential interventions, which were cost-effective and tackling one of the top 20 ranked diseases, were identified.</p> <p>Provision had increased in nearly all EHP services over the period of the SWAp. The rates of out patient attendances and inpatient days per 1000 population had both increased from 929 attendances in 2002/3 to 1135 in 2007/08 and from 124 inpatient days in 2002/03 to 179 in 2007/08.</p> <p>However, by 2007/08 the mean gap between what was required and what was provided was 0.68 of the estimated need. Two services involving the treatment of malaria were overprovided, but the majority were underprovided, with some such as maternity care providing less than half of what was required.</p> <p>The EHP was under-funded throughout the period covering on average 57% of necessary costs. By 2007/08 the funding paid by SWAp partners including the government of Malawi to fund the EHP was at US$13.5 per capita per annum, which was almost half of the revised EHP estimated required expenditure per capita per annum.</p> <p>Discussion</p> <p>The SWAp had invested in some very cost-effective health interventions. In terms of numbers of patients treated, the EHP had delivered two thirds of the services required. This was despite serious under-funding of the EHP, an increase in the population and shortage of staff.</p> <p>Conclusions</p> <p>The identification of interventions of proven effectiveness and good value for money and earmarked funding through a SWAp process can produce measurable improvement in health service delivery at extremely low cost.</p

Adolescent and Youth Sexual and Reproductive Health Survey, Survey Report 2014, Burundi

No abstract available

Adolescent and Youth Sexual and Reproductive Health Survey: Survey Report 2014, Democratic Republic of Congo

No abstract available

Evaluation of UNFPA Support to Adolescents and Youth 2008-2015

The purpose of this evaluation is to assess the performance of UNFPA in its support to adolescents and youth during the period 2008-2015. The evaluation aims to facilitate learning, capture good practices and generate knowledge from UNFPA experience across a range of programmatic interventions in support of adolescents and youth. This is a thematic global evaluation and includes all countries in which UNFPA provided support to adolescents and youth between 2008 and 2015, and addresses the country, regional and global levels. The evaluation results will be used to inform the development of the new UNFPA strategic plan and implementation of adolescents and youth interventions within the framework of the 2030 Agenda for Sustainable Development

Evaluation of UNFPA Support to Adolescents and Youth 2008-2015

The purpose of this evaluation is to assess the performance of UNFPA in its support to adolescents and youth during the period 2008-2015. The evaluation aims to facilitate learning, capture good practices and generate knowledge from UNFPA experience across a range of programmatic interventions in support of adolescents and youth. This is a thematic global evaluation and includes all countries in which UNFPA provided support to adolescents and youth between 2008 and 2015, and addresses the country, regional and global levels. The evaluation results will be used to inform the development of the new UNFPA strategic plan and implementation of adolescents and youth interventions within the framework of the 2030 Agenda for Sustainable Development

Additional file 4 of Whole-genome sequence-informed MALDI-TOF MS diagnostics reveal importance of Klebsiella oxytoca group in invasive infections: a retrospective clinical study

Additional file 4: Table S2. Cellular fatty acid composition of 11 Klebsiella spp. strains