Planning and investing in digital health information systems can lead to improvements in decision-making, patient services, and quality of care. With increased internet connectivity, Pacific island countries have more opportunities to move away from paper-based information systems and connect remote health facilities for greater information exchange. This guide provides resources for those working in health information planning, design, and implementation, including in public health, and includes examples from across the Pacific. The guide makes recommendations on how to achieve a comprehensive and sustainable digital health information system that improves decision-making and, ultimately, improves patient experiences.
This paper has two objectives: (1) assess the health sector performance of the Philippines relative to other ASEAN member states, and (2) assess regional health integration and cooperation in the Philippines, and identify challenges and opportunities. The Philippines is lagging in critical health outcome and access indicators in the region. This is a reflection of the longstanding challenges in terms of health financing, health service delivery, governance, and health human resources. Health integration and cooperation could be instrumental in achieving health system goals. While the country has made significant stride in facilitating regional integration and cooperation in recent years, challenges related to regulations, infrastructure, and implementation remain.
Sri Lanka has experienced a significant fall in the overall smoking rate among males - from 40.5% in 2005 to 28.4% in 2018. Yet worryingly, tobacco smoking prevalence is significantly high among certain groups (referred to as 'Last Mile Smokers') and the country loses more than 20,000 lives every year as a result of tobacco-related diseases. The presence of high prevalence smoking groups highlights the need for successful and sustainable tobacco control measures. Smoking cessation interventions play a significant role in effective tobacco smoking controlling. Different approaches in cessation should be used in different settings – and in combination with one another to improve the effectiveness. Currently, Sri Lanka has a wide range of cessation support. However, IPS studies on tobacco control show that there is a vast unmet demand for tobacco cessation services and community-based smoking cessation interventions are more suitable in the Sri Lankan context.
Smoking cessation policies and programmes play an important role in controlling smoking and tobacco usage effectively. Given that tobacco products contain nicotine, a highly addictive drug on par with heroin and cocaine, smoking cessation is often a difficult and long-term process. Using evidence-based cessation programmes significantly increase the likelihood of successfully quitting the habit. Offering help to quit tobacco use is one of the six major policy components of the World Health Organization's (WHO) MPOWER policy package.
Noncommunicable diseases (NCDs) have become the major cause of disease burden in the Philippines. In 2019, NCDs accounted for about 70% of the 600,000 deaths nationwide; this is projected to increase in the medium to long-term. The premature deaths due to NCDs are increasing in a much faster rate in poorest communities in the country while declining in relatively rich areas. The growing burden of NCDs in poor communities have implications on the poverty reduction efforts and economic prospects of the country. Despite the growing threat of NCDs, the Philippine health system remains historically designed and oriented to address infectious diseases and maternal and child health. This has led to episodic and fragmented delivery of health services - a model that has difficulty handling NCDs. As the country embarks to institute major reforms in the Universal Health Care Act towards a primary health care-oriented and integrated health system, this study will identify the specific challenges in governance, financing, service delivery, and health human resources that hinder the realization of comprehensive and continuous delivery of NCD services in local communities.
The purpose of this discussion paper is to help stakeholders understand and consider the issues when developing a new generation medicines policy, so that it is fit for the future.
The Asian Development Bank seeks to assist the Government of Armenia in undertaking major health financing reforms to achieve universal health coverage (UHC) within the context of the Sustainable Development Goals and improving health system performance. Critical to the development, evaluation and implementation of such UHC policies is the need for accurate information of the expenditure implications and revenue needs of alternative policy choices. This report provides guidance in the design, construction, calibration, evaluation, implementation, use, and refinement of a UHC model to assess the expenditure impacts and the revenue requirements to finance alternative universal health insurance (UHI) policies. It develops an actuarial UHC costing model that relies on the most recent and complete health insurance claims data to estimate expenditures and revenue needs for achieving UHC. The report focuses on the development and operationalization of this actuarial model as a tool for assessing the health financing and fiscal implications of Armenia's key UHI policy decisions.
The coronavirus disease (COVID-19) is causing an unprecedented global impact on cities across the world. This guidance note aims to support cities in developing member countries of the Asian Development Bank (ADB) to effectively and immediately respond to the crisis, and to "build back better" in the short and medium terms. It is anchored to the principles outlined in ADB's Strategy 2030 Operational Plan for Priority 4: Making Cities More Livable and also considers the public health and economic impacts of the pandemic. The guidance note is one of a series produced by ADB for key sectors and thematic areas.
This Perspective first examines undernutrition and its consequences in Malaysia, outlining some factors behind the phenomenon's recent national resurgence. The essay then goes on to discuss key issues regarding obesity in Malaysia, before outlining the weaknesses and strengths of Malaysia's public health policies in dealing with the malnutrition paradox. Particular attention is paid to school feeding programmes and why they have not been as effective as they could have been in tackling the double burden. The Perspective concludes with several policy recommendations.
Caseload midwifery is community-based and at the front line of perinatal public health interventions and outcomes. NZIER was commissioned to investigate the contribution of midwifery to improving health outcomes. Pay and conditions were not the main focus of the project, but this emerged as an underlying factor in the sustainability of improving perinatal health outcomes. The workforce faces challenges from increasing medical and social complexities, which are demanding more time per pregnancy than is allowed under section 88 of the New Zealand Public Health and Disability Act 2000. Pay and conditions is a factor in retention issues. Studies have shown that, for low-risk pregnancies, midwifery can reduce the risk of interventions such as caesarean section, contributing to better health outcomes and health system savings. Adequate training, resources and integration are critical in achieving those outcomes. In this report, the challenges faced by midwifery are investigated and recommendations are made to improve the sustainability of resources for midwifery in New Zealand.
More than 25 years into the implementation of the Local Government Code of 1991, it is inconclusive whether fiscal decentralization indeed improves health service delivery in the Philippines. There is lack of studies that employ rigorous quantitative approach to address the research issue at hand. In this regard, the study attempts to contribute to the small body of literature and motivate further research and generation of reliable data that are crucial for evidence-based/informed policymaking. In particular, the study proposes an analytical framework that examines the effects of fiscal decentralization on health service delivery using difference-in-differences (DID) method. It draws up the standard measure of the extent/degree of fiscal decentralization affecting the health sector. Such endeavor is the first ever attempt to measure the extent/degree of health devolution in the Philippines, i.e., in terms of the health expenditure decentralization ratio. The output variables of interest include access to safe water and sanitation, health facility-based delivery, and access to hospital inpatient services. The control variables include two measures of fiscal decentralization to account for financial/fiscal autonomy of the local government units (LGUs) on the income side (i.e., the ratio of LGU own-source revenue to LGU expenditures and ratio of LGU own-source revenue to LGU income); LGU health spending as a proportion of total LGU expenditures; and per capita LGU income. The choice of variables was constrained by unavailability of disaggregated data at the LGU level. The findings of the DID analysis suggest that greater health decentralization has negative impact on access to hospital inpatient services and access to sanitation (toilet). It contradicts the hypothesis of the study that expects greater health decentralization to result in better health services. Nevertheless, it is consistent with the narrative in the literature that points out the lower province-level spending on hospitals due to mismatch between the cost of devolved hospitals and the internal revenue allotment (IRA), i.e., block grant transferred to the LGUs. Such negative effect has remained over the years because most LGUs do not have adequate health budget to maintain and upgrade devolved health facilities.
NZIER was asked to determine the economic contribution of clinical trials to the New Zealand economy in terms of: 1. Direct economic contribution; 2. Indirect economic contribution 3. Total economic contribution. We were also asked to provide a qualitative assessment of the benefits to New Zealand's health sector from conducting clinical trials in New Zealand. To ensure reliability of our analysis, we have narrowed our scope to pharmaceutical-type clinical trials recommended for approval by the Health Resource Council's (HRC) Standing Committee on Therapeutic Trials (SCOTT) (henceforth, 'SCOTT trials'). These trials are exclusively of interventions that meet the definition of "new medicines" under New Zealand legislation. This means our estimates are conservative as they do not capture the entire clinical trials sector in New Zealand.
This report considers the opportunity of greater use of physiotherapy to contribute to better health and economic outcomes for those with low pain back pain, stroke, and osteoarthritis. These three conditions were selected as leading examples of the potential that physiotherapy could address if the funding and health sector support was put in place. Each of these conditions ranks in the top 10 non-communicable causes of health quality loss in New Zealand.
Coronavirus disease (COVID-19) has unleashed unparalleled challenges. At the same time, it offers a window to rethink Asia's most fundamental development policies and strategies to address inequality, socioeconomic vulnerability, and environmental challenges. This publication gathers blogs and short policy pieces contributed by ADB staff and experts in an attempt to tackle immediate challenges and prepare for what may lie beyond the horizon. It covers a broad range of development challenges and highlights the crucial role of rapid adoption of digital technologies, adequate supply of quality infrastructure, disaster risk management, and strengthening regional cooperation for a resilient and sustainable future by shaping post-pandemic conditions.
Singapore, a multiethnic country with one of the highest median incomes in the world, is undergoing a demographic shift. Twenty-five percent of the population is predicted to be aged 65 and older by 2030, versus 14.4% in 2019. This demographic shift has profound implications on the country's health and care needs. In response, Singapore has been moving toward a more holistic view of aging, health, and care, along with policies and systems related to these.
