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Health facility assessments provide important data to measure the quality of health services delivered to populations. These assessments are comprehensive, resource intensive, and periodic to inform medium- to-longer-term policies. However, in absence of other reliable data sources, country decision makers often rely on outdated data to address service delivery challenges that change more frequently. High-frequency phone surveys are a potential option to improve the efficiency and timeliness of collecting time-sensitive service delivery indicators in-between comprehensive in-person assessments. The objectives of this study are to assess the reliability, concurrent criterion validity, and non-response rates in a rapid phone-based health facility assessment developed by the Global Financing Facility’s FASTR initiative compared to a comprehensive in-person health facility assessment developed by the World Bank’s Service Delivery Indicators Health Program. The in-person survey and corresponding in-person item verification will serve as the gold standard. Both surveys will be administered to an identical sample of 500 health facilities in Tajikistan using the same data collection entity. To assess reliability, percent agreement, Cohens Kappa, and prevalence and bias adjusted Kappa will be calculated. To assess concurrent criterion validity, sensitivity and specificity will be calculated, with a cut-off of.7 used for adequate validity. The study will further compare response rates and dropout rates of both surveys using simple t-tests and balance tests to identify if the characteristics of the phone-based and in-person survey samples are similar after accounting for any differences in survey response rates. The results of this study will provide important insights into the reliability and validity of phone-based data collection approaches for health facility assessments. This is critical as Ministries of Health seek to establish and sustain more continuous data collection, analysis, and use of health facility-level data to complement periodic in-person assessments to improve the quality of services provided to their populations.

The COVID-19 pandemic brought to the fore long-standing inequities that resulted in certain already-vulnerable groups bearing a disproportionate burden of the disease. The poor have worse health outcomes and access to care, and live and work in inferior conditions, leading to a greater risk of severe illness and death.

This Policy Research Report examines one specific policy approach to improving effective coverage: financial incentives in the form of performance-based financing (PBF) or financial incentives to health workers on the front lines.

Economic theory predicts that abortion laws affect sexual behavior since they change the marginal cost of having risky sex. We estimate the impact of abortion laws on sexual behavior by reported gonorrhea incidence. Our data panel includes 41 countries for which consistent gonorrhea data are available for 1980-2000. Compared with laws permitting abortion only to save the pregnant woman's life or her physical health, the switch to more liberal abortion laws is associated with large increases in reported gonorrhea incidence. Our results help explain why birth rates do not decline at the same rate abortions increase when laws are liberalized.

Dans de nombreux pays à faible revenu et à revenu intermédiaire, la couverture sanitaire s'est considérablement améliorée au cours des deux dernières décennies, mais pas les résultats en matière de santé.

The reform of the US health-care system is being pushed by the current US administration. This article looks at the organisation and the strengths of the present health-care system and discusses the current reform proposals. [PUB ABSTRACT]

Der Umbau des US-amerikanischen Gesundheitssystems ist eines der Vorhaben der gegenwärtigen US-Regierung. Der folgende Beitrag stellt die Organisation und die Leistungsfähigkeit des derzeitigen Gesundheitswesens vor und diskutiert die aktuellen Reformvorschläge.

Der Umbau des US-amerikanischen Gesundheitssystems ist eines der Vorhaben der gegenwärtigen US-Regierung. Der folgende Beitrag stellt die Organisation und die Leistungsfähigkeit des derzeitigen Gesundheitswesens vor und diskutiert die aktuellen Reformvorschläge.

In 2008, the German statutory health insurance funds that provide health insurance to about 90% of the population spent almost one fifth of their total EUR 160.8 billion budget on pharmaceuticals. Meanwhile, expenditures on pharmaceuticals have been increasing at an average annual growth rate of more than 5% over the last decade, and thus more rapidly than overall healthcare spending. The increase in pharmaceutical spending is primarily driven by patent-protected drugs (PPD). A question of basic relevance for the pricing and reimbursement of a PPD is whether or not it offers additional therapeutic value over existing treatments, and thus deserves the advantages of patent-protection in the first place. To regain cost control, lawmakers have taken a variety of direct and indirect measures to regulate PPD prices. These regulations attempt to sidestep the principle of free price setting and full reimbursement of PPDs. The new government's reform proposal represents a radical change in policy.

Financial incentives for health providers and households are increasingly used to improve reproductive, maternal, and child health service coverage in low- and middle-income countries. This study provides a quantitative synthesis of their effectiveness. A systematic review was conducted of the effects of performance-based financing, voucher, and conditional cash transfer programs on six reproductive, maternal, and child health service indicators, with eligible evidence coming from randomized controlled trials and studies using double-difference, instrumental variables, and regression discontinuity designs. Four literature searches were conducted between September 2016 and March 2021 using seven academic databases, Google Scholar, development agency and think tank websites, and previous systematic reviews. Random effects meta-analysis was used to obtain mean effect sizes. From 58 eligible references 212 impact estimates were extracted, which were synthesized into 130 program-specific effect sizes. Financial incentives increase coverage of all considered reproductive, maternal, and child health indicators, but mean effects sizes are of modest magnitude. Effect size heterogeneity is typically low to moderate, and there is no indication that study bias risk, baseline indicator levels, or a combination of provider- and household-level incentives impact effect sizes. There is, however, weak evidence that mean effect sizes are somewhat smaller for performance-based financing than for voucher and conditional cash transfer programs, and that the increase in income, rather than the incentive itself, drives coverage improvements. Financial incentives improve reproductive, maternal, and child health service coverage. If future research confirms the preliminary finding that performance-based financing has smaller effects, voucher and conditional cash transfer programs are the preferred policy option among incentive interventions to achieve higher reproductive, maternal, and chil