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Health financing and payment, results-based financing, social protection, conditional cash transfer programs, noncommunicable disease, maternal and child health
Amanda Glassman is executive vice president and senior fellow at the Center for Global Development and also serves as chief executive officer of CGD Europe. Her research focuses on priority-setting, resource allocation and value for money in global health, as well as data for development. Prior to her current position, she served as director for global health policy at the Center from 2010 to 2016, and has more than 25 years of experience working on health and social protection policy and programs in Latin America and elsewhere in the developing world.
Prior to joining CGD, Glassman was principal technical lead for health at the Inter-American Development Bank, where she led policy dialogue with member countries, designed the results-based grant program Salud Mesoamerica 2015 and served as team leader for conditional cash transfer programs such as Mexico’s Oportunidades and Colombia’s Familias en Accion. From 2005-2007, Glassman was deputy director of the Global Health Financing Initiative at Brookings and carried out policy research on aid effectiveness and domestic financing issues in the health sector in low-income countries. Before joining the Brookings Institution, Glassman designed, supervised and evaluated health and social protection loans at the Inter-American Development Bank and worked as a Population Reference Bureau Fellow at the US Agency for International Development. Glassman holds a MSc from the Harvard School of Public Health and a BA from Brown University, has published on a wide range of health and social protection finance and policy topics, and is editor and coauthor of the books What's In, What's Out: Designing Benefits for Universal Health Coverage (Center for Global Development, 2017), Millions Saved: New Cases of Proven Success in Global Health (Center for Global Development 2016), From Few to Many: A Decade of Health Insurance Expansion in Colombia (IDB and Brookings 2010), and The Health of Women in Latin America and the Caribbean (World Bank 2001).
Health systems around the world can suffer from a crisis of distrust; patients may question the quality of government clinics and newspapers may expose private hospitals for peddling unnecessary procedures. These are symptoms of volume-based health systems that focus on the quantity of care delivered rather than quality or outcomes. Many countries are accelerating down this path. Hospital construction sometimes surpasses growth of primary care infrastructure. New insurance schemes sometimes expand access to inpatient treatment, without equivalent expansion of community-based prevention. These approaches create lasting structural flaws which increase costs without delivering desired results. As countries commit to universal health coverage (UHC), there is a narrow window to chart a different trajectory toward the common goal of achieving the best health outcomes for the resources invested.
In low- and middle-income countries, a hospital is often the first stop for citizens that experience illness, or the last stop when their health needs aren’t met by primary care. And as countries grow economically, the demand for quality health services at all levels will grow.
Despite improvements in censuses and household surveys, the building blocks of national statistical systems in sub-Saharan Africa remain weak. Measurement of fundamental statistics such as births and deaths, growth and poverty, taxes and trade, land and the environment, and sickness, schooling, and safety is shaky at best.
Global health action has been remarkably successful at saving lives and preventing illness in many of the world’s poorest countries. This is a key reason that funding for global health initiatives has increased in the last twenty years. Nevertheless, financial support is periodically jeopardized when scandals erupt over allegations of corruption, sometimes halting health programs altogether.
Kellyanne Conway called him a “man of action” after a whirlwind first week in which President Trump signed 14 Executive Orders and presidential memoranda, covering most of his key campaign issue areas from health to immigration to trade. In a series of blogs, CGD experts have been examining how some of these specific policy intentions could impact development progress. As you would expect from a group of economists, we believe in—and encourage—evidence-based policymaking, and here we look at what the existing evidence and research tell us about how likely these Executive Orders are to achieve the president’s stated goals.
After a decade of rapid growth in average incomes, many countries have attained middle-income country (MIC) status, while poverty hasn’t fallen as much as one might expect. As a result, there are up to a billion poor people or a ‘new bottom billion’ living not in the world’s poorest countries but in MIC. Not only has the global distribution of poverty shifted to MIC, so has the global disease burden. The paper describes trends in the global distribution of poverty, preventable infectious diseases, and health aid response to date and proposes a new MIC strategy and components, concluding with recommendations.
This paper briefly assesses the Health Systems Funding Platform and finds that its progress differs little from prior initiatives, although it does present an opportunity to make global health aid more effective.
Conditional Cash Transfer (CCT) programs are one way to create incentives for poor people to use preventive healthcare services. Evaluations show that CCT programs work, and their use is spreading rapidly throughout the developing world. This paper analyzes key features of CCT programs and offers practical advice for their future design.