This research report examines how community organisations responding to HIV can be effectively supported. The report uses case studies to illustrate seven different models for supporting community organisations through a combination of funding, capacity building and networking. These models show the importance of tailoring funding and support according to an organisation’s needs, size and stage of development. These case studies also highlight the importance of providing multi-year funding to allow organisations to grow and the usefulness of horizontal learning and networking. Each of the models have the potential to be replicated or scaled-up.
Resource allocation and health financing
Models for funding and coordinating community-level responses to HIV/AIDS
Birdsall K, Ntlabati P, Kelly K, Banati P: Centre for AIDS Development, Research and Evaluation, South Africa, 2007
Poverty Reduction Budget Support (PRBS) in Zambia Joint Annual Review 2007: Learning assessment
Gerster R, Chikwekwe M: Southern African Regional Poverty Network (SARPN), 13 July 2007
Mandated jointly by the Government of the Republic of Zambia (GRZ) and the Cooperating Partners (CPs) committed to Poverty Reduction Budget Support (PRBS), the learning assessment (LA), integrated into the Joint Annual Review (JAR) 2007 process, pursued the overall objective of developing practical recommendations on strengthening the effectiveness and efficiency of PRBS-supported programme implementation. The recommendations are based on PRBS experience in general and the 2007 JAR process in particular. The quality of dialogue, performance and accountability was to be specifically assessed. Methodologically, the LA made use of good practices developed elsewhere, observations of JAR sessions, interviews, and written feedback.
The macroeconomic consequences of financing health insurance
Deloach DB, Platania JM: Social Science Research Network (SSRN), 23 August 2007
Employer-financed health insurance systems, like those used in the United States, distort firms labor demand and adversely affect the economy. Since such costs vary with employment rather than hours worked, firms have an incentive to increase output by increasing worker hours rather than employment. This paper constructs a heterogeneous agent general equilibrium model where individuals differ with respect to their productivity and employment opportunities. The authors generate steady state results for several alternative models for financing health insurance: one in which health insurance is financed primarily through employer contributions that vary with employment; a second where insurance is funded through a non distortionary, lump-sum tax; and a third where insurance is funded by a payroll tax. They further measure the effects of each of the alternatives on output, employment, hours worked and inequality. These findings can be compared with East and Southern African communities that employ such employer-financed health insurance systems.
Emergency plans needed to bridge health financing gap
Richards T: World AIDS Campaign, 12 July 2007
The World Health Assembly has in the past three years passed several resolutions on health financing and health worker shortages - yet there has been an overall increase in annual African deaths resulting from lack of sustainable health finance and health worker shortages. The worlds Health Ministers must now move from passing resolutions to effecting resolutions and emergency action to end the deaths of over 8 million Africans a year from preventable and treatable diseases.
Equity in health care in Namibia: Developing a needs-based resource allocation formula using principal components analysis
Zere E, Mandlhate C, Mbeeli T , et al, International Journal for Equity in Health 2007, 6:3, 29 March 2007
The pace of redressing inequities in the distribution of scarce health care resources in Namibia has been slow. This is due primarily to adherence to the historical incrementalist type of budgeting that has been used to allocate resources. Those regions with high levels of deprivation and relatively greater need for health care resources have been getting less than their fair share. To rectify this situation, which was inherited from the apartheid system, there is a need to develop a needs-based resource allocation mechanism. Principal components analysis was employed to compute asset indices from asset based and health-related variables, using data from the Namibia demographic and health survey of 2000. The asset indices then formed the basis of proposals for regional weights for establishing a needs-based resource allocation formula.
New Zambian SADC leadership must make 15% health pledge priority
Africa15percentcampaign, 21 August 2007
The Africa Public Health Rights Alliance “15% Now!” Campaign has called on the new Chair of SADC President Levy Patrick Mwanawasa to make it a priority of his term of office to ensure that alongside upholding Democracy and Good Governance, all SADC countries emulate the leadership of Botswana and meet the Abuja African Union pledge to allocate at least 15% of national budgets to health. President Mwanawasa assumed SADC leadership at the end of the last summit that ended on the 17th of August. In a statement issued in Lusaka, the Campaigns coordinator Rotimi Sankore stated:“SADC leaders must realise that they have no choice but to follow the lead of Botswana in meeting the Abuja 15% pledge. Its really a choice between meeting the 15% commitment now, or presiding over mass burials of citizens between now and 2015 when they should have met the health based Millennium Development Goals”.
Public perceptions on national health insurance: Moving towards universal health coverage in South Africa
Shisana O, Rehle T, Louw J, Dirwayi NZ, Dana P, Rispel L: South African Medical Journal 96(9) 2006
Since 1994, considerable progress has been made in transforming the South African health care system, implementing programmes that improve the health of the population, and improving access to health care services. However, amid escalating health care costs disparities continue to exist between the public and private health sectors. The implementation of a national or social health insurance remains elusive despite three government-appointed committees on the matter.
Following the Money: Toward Better Tracking of Global Health Resources
Global Health Indicators Working Group: Center for Global Development, May 2007
This report calls for a move from tracking expenditures on specific health programs in an uncoordinated way to coherent and long-term support to improve government budgetary and financial systems in the developing world; to institutionalizing standard approaches to documenting and analyzing health sector expenditures; and to providing more timely, predictable and forward‑looking data on external assistance to the health sector.
Economic impact of abortion related morbidity and mortality: modelling worldwide estimates
Vlassof M: Eldis Health Resource Guide, 2006
This paper estimates the monetary costs of the 19 million unsafe abortions that take place every year around the world. This includes the direct costs of treatment related morbidity and mortality to health systems, and indirect costs to the national economy and households – the cost to women when they suffer from abortion complications whilst they receive treatment and recuperate from such treatment.
How can we make aid to civil society more effective in overcoming poverty?
Southern Africa Trust: Policy Brief 1, June 2007
About one-third of foreign aid from developed countries is now channelled through or directly to civil society in developing countries. There is a significant change in the way donors give support to civil society, including pooling donor support through national and regional intermediaries; multiple funding agencies and adoption of a variety of support models. Based on a detailed analysis of seven country case studies (Botswana, Lesotho, Malawi, Namibia, South Africa, Zambia and Zimbabwe), the findings challenge the conventional wisdom and advance the civil society agenda in certain key ways.