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This book portrays the performance of the health sector in Zambia using quantitative techniques. While there have been a number of health sector assessments in the country, they have relied on qualitative and anecdotal evidence for the most part. For the first time, this pubic expenditure review of the health sector brings together the results of three separate but related analytical efforts: multi-year national health accounts, a public expenditure tracking and quality of service delivery survey, and resource and impact modeling using the Marginal Budgeting for Bottlenecks software.

Medical economics --- Public health --- Economie de la santé --- Santé publique --- Economic aspects --- Aspect économique --- Zambia --- Zambie --- Statistics, Medical. --- Statistiques médicales --- Economie de la santé --- Santé publique --- Aspect économique --- Statistiques médicales --- Economics, Medical --- Health --- Health economics --- Hygiene --- Medical care --- Medicine --- Sambia --- GRZ --- Government of the Republic of Zambia --- Republic of Zambia --- Zambië --- Republiek van Zambië --- Zambiya --- Замбія --- Zambii︠a︡ --- Рэспубліка Замбія --- Rėspublika Zambii︠a︡ --- Zambija --- Republika Zambija --- Замбия --- Република Замбия --- Republika Zambii︠a︡ --- Zambijská republika --- Gweriniaeth Zambia --- Republik Sambia --- Sambia Vabariik --- Ζάμπια --- Zampia --- Δημοκρατία της Ζάμπιας --- Dēmokratia tēs Zampias --- República de Zambia --- Zambio --- Zambia Respubliko --- Zambiako Errepublika --- République de Zambie --- An tSaimbia --- Poblacht na Saimbia --- Saimbia --- Yn Tambia --- Pobblaght ny Sambia --- Poblachd Shaimbia --- Tsan-pí-â --- Republica iti Zambia --- Republik Zambia --- Repubblica dello Zambia --- Republika ning Zambia --- Zambi --- Sambi --- Jamhuri ya Zambia --- Repubilika ya Zambia --- Zanbi --- Zambijas republika --- Zambijos Respublika --- Republiki ya Zambia --- Zambiai Köztársaság --- Замбија --- Bu̇gd Naĭramdakh Zambi Uls --- Tlācatlahtohcāyōtl Zambia --- ザンビア --- Zanbia --- Republikken Zambia --- Zambiya Respublikasi --- Republika Zambii --- República da Zâmbia --- Republica Zambia --- Республика Замбия --- Saambiya --- Sambian tasavalta --- Republiken Zambia --- Republika ng Zambia --- Zambiya Cumhuriyeti --- Saambi --- Republik bu Saambi --- 赞比亚 --- Zanbiya --- Northern Rhodesia

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Ukraine is amid a comprehensive health sector reform to transform the current unaffordable and inefficient system into a modern, more efficient, and affordable one. The country's health system is not addressing non-communicable diseases (NCD) and chronic conditions effectively, and NCD-related health outcomes compare relatively poorly to countries with a similar level of health financing. The paper analyzed the continuum of care for four conditions (hypertension, diabetes, breast, and cervical cancer) using the cascade framework as an analytical tool and programmatic data from two regions of Ukraine (Lviv and Poltava). It draws on global evidence of good and cost-efficient practices and includes the findings from guided discussions with Ukrainian health care planners, administrators, and providers. The analysis found significant gaps in detection, treatment monitoring, and treatment adherence in hypertension care (the largest breakpoints were blood pressure monitoring and achieving treatment targets) and similarly in diabetes care (underdiagnosis, inappropriate or incomplete treatment monitoring, sub-optimal treatment success). In breast cancer care, there was inadequate screening coverage among eligible women, post-screening losses, and a lack of documentation regarding treatment outcomes. In cervical cancer care, the screening intervals for covered women were short, creating inefficiencies, while many women were not screened despite program eligibility, and there was also a lack of long-term monitoring of women who had undergone treatment. The authors discuss the methodological approach of analyzing routine medical records and cancer registry data and triangulating data across multiple data sources. Important lessons and policy implications include the need to revise sequence of services, focus on follow up and retention in care, develop systems for managing risk factors, and strengthen the monitoring and data recording of NCD cases. Improved NCD care would save lives, reduce disability, save resources in health care, and reduce the impact of NCDs on individuals and society.

Breast Cancer --- Cancer --- Cervical Cancer --- Diabetes --- Disease Control and Prevention --- Health Service Management and Delivery --- Health, Nutrition and Population