UN Population Division, Department of Economic and Social Affairs,
with support from the UN Population Fund (UNFPA)
|
| UN Population Division, Department of Economic and Social Affairs, with support from the UN Population Fund (UNFPA) |
|
HDDFLASH ISSUE No. 13, February 3, 1997
Electronic Newsletter and Archiving Service on human development issues
World Bank
Human Development Department
E-mail: hddlink@worldbank.org
http:/www.worldbank.org/html/hcovp/hdd/contents.html
_____________________________________________________________________________
In this issue....
* Health Reform in Central Asia
* What's New in the HDDFLASH Archive?
* Conference Announcements
* Vacancy Announcements
* New Publications
HEALTH REFORM IN CENTRAL ASIA
The following is from the abstract of the publication "A Survey of Health
Reform in Central Asia" by Klugman, J.; G. Schieber with the assistance of T.
Heleniak and V. Hon.
This paper surveys health reform in the former Soviet countries of
Central Asia. Reform efforts are evaluated in the context of achieving the
goals of improving people's health status, maintaining access and equity,
improving efficiency, increasing clinical effectiveness, and assuring quality
and consumer satisfaction. The underlying demographic and epidemiological
situation of the population is investigated, alongside the economic trends
associated with the transition from a command system. Present and proposed
health reforms are considered in terms of the inherited strengths and
weaknesses of the Soviet approach to health care as well as the experiences of
Russia and western industrial countries.
In preserving the health gains of the Soviet period, the Central Asian
countries face significant demographic and epidemiological challenges, in the
context of worsening economic constraints. Population growth continues at a
rapid pace and the inherited disease burden reveals disorders that are
typically associated with poorer developing countries, such as high infant and
maternal mortality, as well as significant levels of non-communicable
diseases. National income has declined significantly across the region since
1990, and on the order of 50 percent or more in several countries. Economic
distress and rising poverty at the household level has been associated with
worsening morbidity and mortality. Real health spending per person has
declined by more than 50 percent in every country except Uzbekistan, where it
has declined by one-third.
Yet the extensive and inefficient health infrastructures of the past
remain largely intact. The quantities of inputs -- in terms of numbers of
doctors, beds and hospital admissions -- are still above the levels in western
industrial countries, although they provide poor value for the monies spent
and are not affordable under the current economic circumstances. Public and
environmental health programs are not well targeted to the disease burdens.
The strengths of the old system in terms of equity and universal access are
being threatened by the deterioration of the health infrastructure and
shortages of supplies, as well as increasing out-of-pocket payments that
adversely affect the poor. Pharmaceutical procurement, distribution, pricing,
rational use, and quality are major problems across Central Asia.
There has been a preoccupation in the policy debate with obtaining
additional non-budget revenues to finance the health sector. Typically, far
less attention has been focused on equally important elements of the health
reform agenda. Such elements include public health programs, restructuring
health delivery toward primary care, implementing incentive-based provider
payment mechanisms, the need for better management at all levels of the
system, and the need to modernize or eliminate norms affecting clinical
treatment protocols, facility structural characteristics, and staffing
requirements. The Kyrgyz Republic and Kazakstan have adopted new health
insurance legislation for financing care, but implementation has been delayed
by the depressed economic conditions. Turkmenistan has adopted a publicly-run
voluntary health insurance system that is facing serious financial problems.
There have been experiments with revised provider payment approaches based on
capitation formulae so that general practice physicians and hospitals face
financial incentives to use resources more efficiently. All countries are
attempting to reform their pharmaceutical sectors.
Under serious budget and institutional constraints, the governments of
Central Asia are facing a major challenge in meeting the health needs of their
populations. The extensive and inefficient systems of the past are no longer
affordable and require fundamental restructuring. At the same time, there is
an urgent need to tackle the declining health status of the population.
Nonetheless, experiences to date suggest that methodologies and mechanisms
used in the West to increase the efficiency of the health sector can be
successfully adapted to Central Asia. The implementation of reforms based on
market-based economic principles and modern medical practice standards will be
a major challenge to policymakers and people working in the health sector in
Central Asia.
To order a copy of the report electronically, check the Publications Homepage
at: http://www.worldbank.org/html/extpb/Publications.html
For a mail order copy contact:
The World Bank Bookstore
1818 H St., N.W., Department T-8051
Washington, D.C. 20433
Tel: (202)473-1155 or Fax: (202)522-2627
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What's New in the HDDFLASH Archive?
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The latest volume of New and Noteworthy by Alan Berg highlights successes in
operations; nutrition impacts from Bank policies and actions; encouraging
results from nutrition in the classroom; breakthroughs in agriculture research
and more. It is available in the HDDFLASH archive for your retrieval.
Filename Title
nnnvol28 New and Noteworthy in Nutrition no. 28 (58148 bytes-12/96)
To retrieve this document, send an e-mail message to:
listserv@tome.worldbank.org
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CONFERENCE ANNOUNCEMENTS
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Innovations in Health Care Financing
March 10-11, 1997
Ritz-Carlton Hotel, Arlington, Virginia
The Conference hosted by the World Bank will bring together leading
international experts, reform leaders, country representatives, and World
Bank Staff for two days of discussion on cutting-edge issues related to
health care financing.
Both conceptual and operational contexts for introducing changes in
health care financing will be explored. Key issues include: the
regulation of private health insurance, how to design and administer user
charges, and what conditions are needed for successful risk pooling in
poor and rural communities.
The deadline for registration is Monday, February 10, 1997. Registration
forms should be submitted directly to the Alpha Center P.O. Box 33226,
Washington DC 20033-2336.
For further information, please contact George Schieber at (202)458-7319
or Jillian Cohen at 458-8587 (e-mail: jcohen@worldbank.org) or check the
Alpha Center's website directly at http://www.ac.org/httpdocs/wbank.html
or via our homepage at
http://www.worldbank.org/html/hcovp/heal/contents.html
*****************************************
Call to Action! Strategies to Improve Occupational and Environmental Health in
Central and Eastern Europe
The 8th Annual Symposium on Environmental and Occupational Health during
Societal Transition in Central and Eastern Europe
Sofia, Bulgaria
May 26-31, 1997
Organized/sponsored by: Dept. of Work Environment, University of
Massachusetts-Lowell, Lowell, Massachusetts; JSI Center for Environmental
Health Studies, Boston, Massachusetts; Environmental and Occupational Health
Sciences Institute, Piscataway, New Jersey; Center for International Rural and
Environmental Health, University of Iowa; Swiss Labor Assistance, Zurich,
Switzerland;Swiss Development Cooperation, Bern, Switzerland; Podkrepa:
Confederation of Labor, Bulgaria; CITUB: Conference of Independent Trade
Unions of Bulgaria.
The 8th annual symposium will focus on action strategies. The intent of
symposium organizers is to bring together representatives from NGOs, labor
unions, members of the academic community, representatives of local and
national government, industry, and public policy makers from Eastern, Central,
Western Europe and the U.S.A. to exchange information about successful efforts
to improve workplace and community health.
The program will emphasize existing case studies from different countries to
provide a starting point for discussing strategies of coalition building,
community organizing, project development, tools for successful change
processes, and ways to overcome institutional barriers to change.
Case studies will address different levels of intervention: workplace-based
initiatives, community-focused projects, and efforts to change public policy
at the local, regional, or national level. The case studies will be
followed by small group discussion sessions to critically analyze lessons
learned. Some sessions will focus on transfer of relevant skills. The
symposium will culminate with sessions to promote regional and multi-sector
collaborations as well as diffusion of successful strategies.
Based on these goals the Planning Committee is looking for 8-10 case studies
that represent successful or instructive efforts to address workplace and
community health issues. Possible content areas:
* Reduction/elimination of workplace hazards
* Remediation of environmental hazards at the community level
* Developing pollution/hazard prevention and clean production strategies
* Changing public policy, laws, and regulations to improve workplace and
environmental health
Case studies submitted for consideration should represent multi-sector
coalition efforts and address the following:
* Problem(s) addressed
* Initiators of the action and those involved in the process
* Strategies used
* Barriers to be overcome
* Outcomes of the project and the process
* Lessons learned
Registration
The registration fees are as follows:
*$595 USD for North American and Western European participants who pay by
April 1, 1997; after April 1, 1997, the fee is $695 USD.
* $350 USD for full-time registered students
* $250 USD for Central and Eastern European participants
Limited scholarships and travel reimbursement will be available for Central
and Eastern European presenters/participants; and Community, NGO, and labor
organization participants.
Contact:
Craig Slatin or Joel Tickner
Univ. Massachusetts Lowell
(508) 934-3250; fax (508) 452-5711
slatincr@woods.uml.edu
ticknerj@woods.uml.edu
Gretchen Latowsky
JSI Center for Environmental Health Studies
(617) 482-9485; fax (617) 482-0617
glatowsky@jsi.com
Proceedings of the Symposia are widely distributed; copies of most issues
are still available, free of charge, from the JSI Center for Environmental
Health Studies, 44 Farnsworth Street, Boston, MA 02210-1211 USA.
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VACANCY ANNOUNCEMENTS
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Position: Country Project Manager
Breast Cancer Assistance Program, Ukraine
Location: Kyiv, Ukraine
Job Description:
Manage operations and provide technical assistance for three-year USAID-
funded breast cancer assistance project starting up in Ukraine.
Responsible for advising and coordinating with national center and two
oblasts for successful implementation of diverse clinical and technical
training activities.
Qualifications:
* advanced degree in field related to medicine or public health,
ideally with clinical experience in women's health
* at least 10 years of professional experience
* strong organizational and communication skills
* strong management experience
* understanding of the Ukrainian medical system at the national and
oblast levels
* Proficiency in spoken and written Russian, Ukrainian, and English
The Project Manager will report to the Project Director in Seattle,
Washington. He or she will have lead responsibility for communicating
with the Seattle team, for providing input for project reports, and for
representing the project in discussions with the USAID Mission and the
Ministry of Health.
Contact Information:
KYIV, UKRAINE:
Dmitry Tyshchenko, M.D., PATH/Kyiv
3/4 Malaya Zhitomirskaya Street, Apt. 13
252009 Kyiv, Ukraine
Telephone/Fax: 229-8784 E-mail: kievpath@path-k.carrier.kiev.ua
SEATTLE, WASHINGTON, USA
Kristin Bedell, PATH
4 Nickerson Street
Seattle, Washington 98109
Tel: 206-285-3500; Fax: 206-285-6619; Email: kbedell@path.org
Fax or mail curriculum vitae and letter of interest (in English).
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Position: Technical Officer/Chair, Nutrition Working Group
Location: Washington, D.C.
BASICS is recruiting for a technical officer/chair of its Nutrition Working
Group. BASICS is an international public health project funded by the
United States Agency for International Development. The project provides
technical leadership and practical field programs for reducing infant and
childhood illness.
OVERALL RESPONSIBILITIES: Guiding and contributing to the further
development of BASICS's nutrition strategy to achieve the project's
overall goal in nutrition. The strategy currently has three major
components:
* further the development and implementation of a minimum package
(MINPAK) of nutrition interventions in conjunction with child health
programs;
* the definition and implementation, especially at the community
level, of appropriate child feeding behaviors, including breastfeeding,
weaning, and complementary feeding through the first two years of life;
* testing and promoting widespread use of methods that inform and
persuade decision-makers at all levels of the importance and feasibility of
reducing malnutrition.
Specific tasks will include, but will not be limited to, the following:
* Ensuring the implementation of the nutrition strategy in countries in
which BASICS has periodic or long-term projects;
* Developing meaningful and effective collaboration with other
agencies with similar goals;
* Providing constructive and effective supervision of other
members of the Nutrition Working Group, when appropriate;
* Overseeing the activities of BASICS nutrition subcontractors and
tending to the administrative requirements of the subcontract;
* Ensuring close liaison with BASICS USAID managerial team in
USAID/G/HN, and with the Nutrition Division and with USAID?s Africa
Bureau/Sustainable Development group.
The incumbent will be a member of the Technical Division Management Team.
QUALIFICATIONS:
* M.D. or Ph.D. in a relevant field;
* Demonstrable experience in public health nutrition programs in
less developed countries;
* Three years field experience in a less developed country(s),
preferably in a nutrition-related post;
* Experience and excellence in technical writing and presentation;
* Knowledge of USAID programs and procedures is desirable;
* Ability to work in either French or Spanish is desirable.
SUGGESTED SALARY RANGE: $65,000-90,000 commensurate with prior salary history
PLEASE SUBMIT RESUMES BY: February 14, 1997
CONTACT: Qualified candidates should send a resume and cover letter
to the attention of Luann Martin, AED, 1255 23rd Street, NW,
Washington, DC 20037. Fax: (202)884-8701.
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Position: TB/HIV Epidemiologist
Location: Malawi
The London School of Hygiene and Tropical Medicine is looking for an
epidemiologist to join a new Wellcome-Trust funded program of research on
mycobacterial and HIV infections in Northern Malawi.
The post provides an unusual opportunity to play a major role within a large
research program. Responsibilities include finalizing and field implementation
of protocols.
Requirements: MSc. in epidemiology (or equivalent experience), preferably
clinically qualified, and who is eager for field experience in Africa.
For more information, please contact:
Paul EM Fine VMD, PhD
Professor of Communicable Disease Epidemiology
London School of Hygiene and Tropical Medicine
Keppel St., London WC1E 7HT
Tel: 44 171 927 2219
Fax: 44 171 436 4230
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Position: Fellowship in Health and Human Resources
Location: Institute of Development Studies, Brighton, UK
The Institute of Development Studies, a policy research and training institute
for overseas development, is seeking to recruit a senior Fellow to work on the
roles of the state, non-governmental institutions, community organisations and
households in the determination of health status and the financing and
provision of health services.
Candidates, who need not be exclusively health specialists, should have a
doctoral degree, substantial relevant post-doctoral experience and a
demonstrated capacity for excellence in research. Experience of operational
work in a developing country is essential as is an established record of
publications.
Salary is in accordance with the Universities' Research Faculty Scales, to be
determined by age and experience, with opportunities for income enhancement.
Closing date: 14 March 1997
Interview Date: 30 April 1997
Further details are available on the IDS web site at:
http://www.ids.ac.uk/ids/news/recruit/index.html
Or by contacting:
Mrs Lin Briggs
Institute of Development Studies
University of Sussex
Brighton BN1 9RE
Confidential Fax and Answerphone: 01273-674553 [Int +44 1273]
E-mail: qdfk2@sussex.ac.uk
Application forms will be mailed, so please give your full postal address.
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NEW PUBLICATIONS
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HEALTH IN TRANSITION: REFORMING CHINA'S RURAL HEALTH SERVICES
The latest issue of the Institute of Development Studies Bulletin asks whether
China will be able to maintain cost-effective rural health services as it is
transformed into a market economy. The papers were prepared as an input to the
intense debate on this subject now underway in China, and brings together
contributions from leading health researchers in China and the UK.
The Bulletin explores how the re-organisation of the health sector and changes
in the economic and institutional context within which it operates have
affected the performance of rural health services. It also identify options
for reform. Policy-makers in low- and middle-income countries can learn a
great deal from the experience of the decade's most radical experiment in
health sector reform.
Health in Transition: Reforming China's Rural Health Services is edited by
Gerald Bloom and Andreas Wilkes
IDS Bulletin Vol 28 No 1 1997 120 pages
Copies are available from the IDS Publications Office
Institute of Development Studies, Brighton BN1 9RE, UK.
Tel: (01273) 678269 (Intl. +44 1273) Fax: (01273) 621202 or 691647
E.mail: ids.books@sussex.ac.uk
Price: UK Pounds 9.25 (plus shipping - add UKL 1.85 for UK addresses, and
UKL 2.30 for addresses overseas)
IDS Publications can also be ordered over the Internet through the new
IDS Virtual Bookshop at: http://www.ids.ac.uk/ids/publicat
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ANEMIA DETECTION IN HEALTH SERVICES: GUIDELINES FOR PROGRAM MANAGERS
These guidelines are intended to help program managers establish anemia
detection services or enhance existing services. They include a general
overview of the programmatic issues of anemia screening to provide a context
for method choice. Existing commonly available anemia detection methods are
presented in a standardized format to help managers make apropriate decisions
regarding technology selection.
This book was published by PATH, the Program for Appropriate Technology in
Health, and funded by USAID. Second edition (December 1996) reprints were made
possible through the OMNI Project. This publication is free of charge and
copies available in English through OMNI
OPPORTUNITIES FOR MICRONUTRIENT INTERVENTIONS (OMNI)
1616 North Fort Myer Dr, Suite 1100, Arlington, Virginia
22209 USA - Tel: 703 528-7474 - Fax: 703 528-7480
E-mail: omni_project@jsi.com
WWW: http://www.jsi.com/intl/omni/home
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PROMOTING THE GROWTH OF CHILDREN: WHAT WORKS
This publication by Marcia Griffiths, Kate Dickin, and Michael Favin, has
recently been published by the World Bank as Tool #4 in its Nutrition Toolkit
series. The purpose of the Toolkit is to help World Bank staff design and
supervise effective and feasible nutrition projects, as well as carry out
comprehensive analysis of sectoral and policy issues affecting food
consumption and nutrition. This paper discusses growth promotion activities
as components of successful community nutrition projects with emphasis on how
to design and implement programs that maximize the potential offered by the
growth promotion package in nutrition and primary health care programs.
The cost of the publication is $10.00, and can be ordered through The
Manoff Group (telephone: 202-265-7469; fax: 202-745-1961; email:
internet:74673.762@compuserve.com; address: 2001 S Street, NW,
Suite 510, Washington, DC 20009-1125).