Clear and rigorous evidence on the contributions of US global health programs is more important than ever, as the White House and lawmakers discuss and debate budgets and the future of US support to global health. Such information aids policymakers who must prioritize support to effective public health programs.
CGD Policy Blogs
In 2007, the World Bank established the multi-donor Health Results Innovation Trust Fund (HRITF) to support and evaluate low-income country government efforts to pay providers based on their results in health care, with a focus on reproductive, maternal, newborn, child and adolescent health and nutrition. A decade later, the HRITF has had substantial impact on how governments and aid partners think and talk about health care financing, and the term “results-based financing” or RBF is now well-established in the policy vernacular.
The power and potential of digitized and linked data require careful stewardship. For example, integrating routine data and HIV registers could generate efficiencies and potentially improve the delivery of health care services, but linking these systems may also put individuals’ privacy at greater risk. The ethics of developing, managing, and providing access to data needs to be at the forefront of conversations on data for development, along with practical strategies to proactively protect privacy.
Routine operational data on government programs lack sexiness, and are generally not trendy with Data Revolutionaries. But unlike censuses and household surveys, routine administrative data are readily available at low cost, cover key populations and service providers, and are generally at the right level of disaggregation for decision-making on payment and service delivery. Despite their potential utility, these data remain an under-appreciated asset for generating evidence and informing policy.
At the World Bank’s Annual Universal Health Coverage (UHC) Financing Forum this year, I took part in a mock competition to help determine the topic of next year’s forum. I was up against Larry Gostin, who argued that the 2017 forum should focus on equity and human rights, and Sara Bennett, who made the case for it to be the political economy. My pitch was for the forum to focus on efficiency—or value for money—in UHC reforms, and here’s why.
The quality of healthcare services is firmly on the global health and development agenda: it is explicitly part of SDG target 3.8 on universal health coverage and a key feature of USAID’s Vision for Health Systems Strengthening. To meet these goals, we need data that can support and inform the design of interventions that aim to improve the quality of healthcare.
Recruiting community members with basic training for health promotion and care delivery is increasingly popular among development programs in low- and middle-income countries. This approach has great appeal: it could boost accountability and local ownership, and reduce program costs. Though the potential benefits of the approach are easily touted, the full costs remain murky and are often an afterthought.
Interest in the creation and use of citizen report cards (CRCs) is growing in many low- and middle-income countries. Bangalore has measured and reported citizens’ satisfaction with government agencies to the media; Kenya’s three largest cities have gauged citizens’ access to and use of waste management services; and townships in Myanmar have used CRCs to gather feedback on their provision of health and education services. Interest in social accountability tools is even echoed by officials at the highest levels. At a June summit on measurement and accountability in health, the World Bank, USAID, and WHO agreed to push for the increased use of citizen and community led reviews at every level of service and governance.
Using research to inform policy often involves reading scientific articles in costly books and journals. But for some policymakers and analysts these costs may be prohibitively expensive, leaving them without access to critical information.
For better or worse, there are many lessons other countries can learn from the United States’ experience in health care.