Crossing the quality chasm: Nigeria’s long walk to universal health coverage

Policy Blog
In a recently published blog, my friend Dr Abiodun Awosusi narrated this very touching story: “I walked into the paediatric unit of a teaching hospital in Nigeria a few years ago to review a patient. On the first bed was a lifeless child. He was brought in dead a few minutes earlier by his parents. His mother, “Bisi”, wept uncontrollably. While in tears, she recounted how difficult it was for them to borrow money to get to the hospital. Although they got some money from a chief in the community, the two-year-old baby died before they got to the hospital”. Many households such as this one have been pushed into poverty, debt, and financial hardship as a result of seeking health care. In Nigeria, data from the 2017 National Health…
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Ghana: Healthcare for a Country in Transition

Policy Blog
This blog was first published in Duke Global Health Institute News. The author Mary-Russell Roberson. Among sub-Saharan African countries, Ghana stands out for its high rate of health insurance coverage: About 40 percent of the population has policies available through the National Health Insurance Scheme (NHIS). But the NHIS is costing the government more than expected. A proposed cost-saving policy, called capitation, would pay providers per patient rather than for each service provided. The policy looked good on paper, but failed in a pilot program. Gilbert Abiiro wanted to know why. He’s a lecturer/researcher at the University for Development Studies in Ghana, who recently spent eight weeks at Duke as a fellow of the Center for Policy Impact in Global Health. In Ghana, Abiiro interviewed providers, policymakers, politicians, and people who…
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Preparing for pandemics such as coronavirus—will we ever break the vicious cycle of panic and neglect?

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors are Gavin Yamey, Marco Schäferhoff, Kaci Kennedy McDade, and Wenhui Mao. On January 30, 2020, the World Health Organization (WHO) determined that the outbreak of the 2019 novel coronavirus (2019-nCoV) that originated in China was a Public Health Emergency of International Concern. Although researchers quickly identified and sequenced the virus, our weak global pandemic preparedness system has led to rising numbers of people infected with 2019-nCoV worldwide. The virus is highly transmissible, and is likely to become a pandemic. WHO has requested $675 million for a coronavirus preparedness and response plan. When a pandemic occurs, global health donors rush to provide a burst of pandemic funding. Then, just as we saw in the wake of past outbreaks like the…
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What happens to health financing during the middle-income transition?

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors are Ipchita Bharali and Indermit Gill. As countries move from low to middle income, they experience big shifts in the composition of public and private spending on health. One reason for the change in financing is the eligibility criteria for concessional development assistance: Foreign aid starts to decrease after countries move into middle income. This is evident from a snapshot of health expenditures across the income spectrum, used to proxy what happens to a country as its per capita income increases. Figure 1 charts health expenditures by source for countries organized from lowest to highest GDP per capita in year 2015; charts for 2000, 2005, and 2010 look similar. The black vertical lines mark the gross national income (GNI)…
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My Experience as a Global Health Policy Fellow

Policy Blog
My Experience as a Global Health Policy Fellow I have recently finished a two-month global health policy fellowship at the Center for Policy Impact in Global Health (CPIGH). This fellowship program is aimed at mid-career health professionals from CPIGH’s partner countries. As a researcher with the Health Policy Research Group, University of Nigeria, my main research interests are health services; health systems governance and accountability; analysis of health policies, plans and strategies; and getting research evidence into policy and practice. And so, when I discovered that my application for the fellowship at CPIGH was successful, I looked forward to opportunities to deepen my capacity in the field of global health policy and systems, which I hoped would help me to make a more impactful contribution to global heath. Working as…
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The 5 problems China must tackle now to achieve the 2030 health SDGs

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors are Shu Chen, Wenhui Mao, and Shenglan Tang. China made impressive gains during the Millennium Development Goal (MDG) era. According to the Report on China’s Implementation of the Millennium Development Goals (2000-2015), China’s achievements included the following: “The number of medical technicians and staff per thousand people rose from 3.63 people in 2000 to 5.40 people in 2014, and the number of beds per thousand in medical and health institutions increased from 2.38 in 2000 to 4.77 in 2014. … The under-five child mortality rate dropped from 61.0% in 1991 to 12.0% in 2013; the gap between urban and rural areas in child mortality rate was narrowed from 1:3.4 to 1:2.4; the maternal mortality rate dropped from 88.8 per…
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What donors can learn from the Global Polio Eradication Initiative’s transition

Policy Blog
Our Policy Associate, Kaci Kennedy McDade, attended the 2019 World Health Summit in Berlin. This blog is her reflection on the Summit. At the World Health Summit last month, I attended a session on finishing the last mile of polio eradication. At the session, panelists described the remarkable gains that have been made over the last three decades. For example, since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, poliovirus cases have decreased by over 99% and polio remains endemic in only three countries (Afghanistan, Nigeria, and Pakistan). Although we have not yet achieved global polio eradication, a key topic of the discussion that may have surprised some attendees was transition. By transition, I mean the phase-out and withdrawal of polio-focused support. While some participants may have…
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Financing Global Public Goods for Health: How Can We Make the Case?

Policy Blog
On September 19, 2019, our Center Director Gavin Yamey gave a video presentation at the 5th Annual Public Policy Conference in the Philippines. The conference was called “Navigating the New Globalization: Local Actions for Global Challenges.” Dr. Yamey’s presentation was on financing global public goods for health.  The blog below is an updated version of his talk. I am delighted to have the opportunity to talk to you today about financing of what we at the Center for Policy Impact in Global Health call “global functions,” and what the World Health Organization (WHO) is calling global common goods for health. The work that I will be presenting today is part of a new program of work led by the WHO on Financing Common Goods for Health, published in a special…
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What makes a successful international global health or development commission?

Policy Blog
Our Center Director Gavin Yamey is chairing the Advisory Board for the new Lancet Commission on Hearing Loss.  Yesterday, at the first meeting of the Commission, hosted by Duke University, he gave a 10-minute talk on what makes a successful international global health or development commission. Below we post his talk. Last year, I led the writing of a peer-reviewed paper published in the journal Health Policy & Planning called “How to Convene an International Health or Development Commission: Ten Key Steps.” The authors were all involved in Global Health 2035: A World Converging in a Generation, aka the Lancet Commission on Investing in Health (the CIH). Three of us—myself, Larry Summers, and Dean Jamison—were commissioners and one of us, Jessica Brinton, was from the Bill & Melinda Gates Foundation,…
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How do global health academics “reach the people”?

Latest News from the Center, Policy Blog
Today, at the Triangle Global Health Consortium annual conference, our Center Director Gavin Yamey was a panelist on a panel called “Reach the People: How to Communicate Global Health Issues and Solutions.” Below, we post his 10-minute panel presentation. In the next 10 minutes, I’m going to try and answer the question: How does a global health academic like me “reach the people”? I’m taking a bit of liberty in thinking about who “the people” are.  I direct a global health policy center at Duke, and for us our key engagement is with a broad array of policymakers – global health funders, foundations, ministries of health and finance, NGOs, and so on. We want our analytic work to influence the conversations, the debates, the dialogue among these global health actors.…
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