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Over the last decade, results-based financing (RBF) health programs have been implemented in several countries at different levels of income. Due to its requirement of rigorous verification of results as a condition for financing, as well as a number of accompanying measures to help achieve the results, RBF has a promise of value for money. RBF's potential for improving the performance of the service delivery system has led the government of Vietnam to undertake a pilot of RBF in the Nghe An province as part of a World Bank funded operation. The main objective of the pilot was to experiment an RBF approach in the Vietnam context, where public sector providers have been receiving budget allocation based on inputs rather than performance. A secondary objective was to test the effects of RBF in improving quality of care at the grassroots level and in addressing the challenges of emerging noncommunicable diseases. The intervention included quality improvement at the district level and both quality and quantity of services at commune health station.

Health Service Management And Delivery --- Health, Nutrition And Population

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Birth certificates are the cornerstone for establishing legal identity around the world. Despite their importance, birth certificates are frequently simple, handwritten paper documents or computerized printouts, submitted with little attention to security. The birth certificate issuance process is often decentralized, potentially leading to different formats within the same country. These features make birth certificates relatively easy to forge and difficult to authenticate. In many countries, applying for a passport requires the submission of a birth certificate, a process that can be inefficient, and at the same time may not enable the full authentication of individuals. A similar situation may exist in other circumstances, for instance, when applying for school or university admission, driver's licenses, marriage and separation certificates, and welfare benefits; enrolling for health care or health insurance; or registering to vote. One way to solve this problem is to make the birth certificate a highly secure document (like a banknote or passport), with personalization and issuance completed under highly secure conditions. Some countries are using a digital birth certificate (DBC). The birth certificate as a digital credential has become relevant in the context of sustainable development goal. Given the increasing digitization of state records and processes, as well as greater connectivity among departments, a DBC, if issued in a secure manner, can enable more timely processing and a greater level of authentication. In addition to having the capacity and administrative processes in place to manage DBCs, countries require a corresponding legal framework to recognize DBCs. This guidance note provides select country examples of manual and electronic birth registration and certification processes and discusses the principal requirements for moving toward DBCs, with suggestions on how to meet the requirements.

Health Service Management and Delivery --- Health, Nutrition and Population --- ICT Applications --- Information and Communication Technologies

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This report summarizes key findings from the endline assessment of the pilot project, Improving Birth Registration Using Existing Community Structures and Immunization Processes. The project was undertaken in Yilmana Densa and Goji Qolela woredas (districts); Hintalo Wajirat and Enderta woredas; and Amibara and Awash Fentale woredas, which are the intervention and control woredas in Amhara, Tigray, and Afar regions, respectively. The overall objective was to enhance a well-functioning civil registration and vital statistics (CRVS) system by integrating community health structures with civil status offices. This assessment was quasi-experimental by design and used longitudinal data, supplemented by a methodology like the one used in the baseline survey to compare improvements in key variables. The assessment compared intervention and control groups, with measuring use of civil registration services, and compared the outcome of the CRVS service provision in terms of improvement. The assessment used qualitative and quantitative methods of data collection and analysis. Some of the key findings of the assessment include: After introduction of the project, the rate of births registered within 90 days increased from the previous year and was greater than in the control woredas; CSOs in the intervention areas regularly visited communities for awareness creation and motivation and for registration when the WDA invited them; qualitative data from KIIs and FGDs generally indicate that the large increase in birth registration in Afar was the result of the presence of CSOs at the kebele level, community mobilization, and no civil status office staff turnover during the project; the community consistently reviewed the registration progress monthly, identifying challenges faced and ways forward at the kebele level, and noted this in the minutes.

Health Service Management and Delivery --- Health, Nutrition and Population --- Immunizations --- Information and Communication Technologies

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This report summarizes the findings of an allocative efficiency analysis on Belarus` national HIV epidemic and response conducted in 2014-15. The report addresses core questions for resource allocation such "How can HIV funding be optimally allocated to the combination of HIV response interventions that will yield the highest impact?" or "What level of investment is required to achieve national targets, if we allocate resources optimally?". The report describes epidemiological and HIV financing trends as well as identifies sub-populations, which are most affected by the epidemic. Based on this information, the optimized mix of interventions for minimizing new HIV infections and deaths is identified using mathematical modelling techniques. Belarus could increase the impact of its HIV program by reallocating funds to high-impact programs. It could enhance this impact by increasing the total funding available to the HIV response so that high-impact programs could be scaled up further. With optimized allocations of the same amount of funding available as in 2013 (USD 19.7 million), over 2015-20, new HIV infections could be reduced by 7 percent and deaths by 25 percent. Doubling the investment in high-impact programs would require 148 percent of total 2013 spending (USD 29.5 million). Compared to 2013 allocations, over 2015-20, the 148 percent investment would achieve a remarkable reduction in new infections by 43 percent and in deaths by 51 percent.

Health Economics & Finance --- Health Service Management and Delivery --- Health, Nutrition and Population

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This report summarizes the findings of an Allocative efficiency analysis on Moldova`s national HIV epidemic and response conducted in 2014-15. The report addresses core questions for resource allocation such 'How can HIV funding be optimally allocated to the combination of HIV response interventions that will yield the highest impact?' or 'What level of investment is required to achieve national targets, if we allocate resources optimally?'. The report describes epidemiological and HIV financing trends as well as identifies sub-populations, which are most affected by the epidemic. Based on this information, the optimized mix of interventions for minimizing new HIV infections and deaths is identified using mathematical modeling techniques. Required investments into programs for key populations and antiretroviral treatment are established and translated into policy recommendations. Moldova continues to experience a concentrated HIV epidemic among people who inject drugs (PWID), men who have sex with men (MSM), female sex workers (FSW), and their clients and their sexual partners in the general population. The HIV epidemic is more severe on the left bank of the Nistru River, where coverage of prevention programs is lower. The country could increase the impact of its HIV response by increasing investment from USD 8.7 million to USD 14.2 million. Optimally allocating resources will result in a 36 percent decrease in incidence and a 48 percent decrease in HIV-related deaths.

Health Economics & Finance --- Health Service Management and Delivery --- Health, Nutrition and Population