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Browse Health Policy Project (2010-2016) Materials

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LAC

  • To successfully lead a strategic, effective and sustainable response to AIDS, individuals must be equipped with a diverse set of skills. However, many individuals rise to leadership positions with purely medical backgrounds and lack essential skills in management, finance, advocacy and policy, and governance. For over a decade the National Institute of Public Health (Instituto Nacional de Salud Pública – INSP), part of the National Health Institutes of the Health Ministry in Mexico, has designed and conducted training courses to augment HIV leaders’ skills in these critical areas and to strengthen the regional AIDS response, particularly in Mexico, Central America, and the Caribbean.

    The USAID-funded Health Policy Project commissioned a case study of INSP’s educational programs to better understand what elements are critical for such programs to be successful, what challenges they face, and to identify opportunities to strengthen and expand regional capacity-building efforts in the future.

    The results indicated that the students surveyed felt INSP’s multidisciplinary training approach for leaders in the region’s HIV and AIDS response fostered a more harmonized response to the epidemic. Further, the lessons and tools learned through INSP modules and courses become a principal resource for former students who go on to play strategic roles in national and state AIDS programs, as well as civil society. INSP course alumni feel better equipped to make decisions based on available evidence, to design and implement strategic prevention and care strategies, and to contribute to policy development. However, challenges remain and to sustain and expand, the INSP and other training initiatives must find ways to reduce course costs and required time commitments without sacrificing the quality and comprehensiveness that has made them so effective.

    Opportunities for continued education and virtual support through networking will also provide critical ongoing support. To maximize impact, curricula should take into account the unique economic, political, social, and cultural characteristics of individual countries; differences in infrastructure and human resources; and the diverse ways the AIDS epidemic manifests across the region. Those interviewed indicated that comprehensive training programs such as those developed by INSP play an essential role in equipping national and regional leaders to improve and expand HIV and AIDS services. The INSP programs fill a critical gap in human resource training and efforts should be made to mobilize the resources and support needed to expand and duplicate these kinds of training opportunities.

  • This report describes two pilot technical assistance programs implemented by the USAID-funded Health Policy Project to strengthen policy development and implementation related to contraceptive security at decentralized levels in Peru and the Dominican Republic. Over a two-year period, three regional and municipal committees engaged a multisectoral group of political leaders, technocrats, civil society representatives, and healthcare providers to collaboratively assess policy and funding barriers related to family planning and design and implement solutions. The compilation of experience and results is intended to inform programs to strengthen contraceptive security at the decentralized level in other settings, whether through committees or other mechanisms. As decentralization continues to evolve in Latin America and other regions, it is critical to strengthen subnational capacity in the public sector and civil society to ensure that high-quality and equitable services are demanded, delivered, and monitored at all levels of the health system in a manner that promotes sustainability and local ownership.

  • This handout provides an overview of the Positive Health, Dignity and Prevention (PHDP) Curriculum created by the Jamaican Network of Seropositives (JN+)—with support from the Jamaican Ministry of Health’s National HIV/STI Program (GIPA Unit) and the USAID- and PEPFAR-funded Health Policy Project. The curriculum aims to promote personal health and advocate for high-quality health services for people living with HIV (PLHIV). Although it was developed in Jamaica, the curriculum offers a promising, practical tool to help strengthen PLHIV leadership and advocacy to advance PHDP in the region and globally, and to enhance health systems and health outcomes across prevention, care, and treatment.

  • Since 2003, the U.S. Agency for International Development's Latin America and the Caribbean (LAC) Contraceptive Security (CS) Initiative has fostered country ownership through CS committees established in eight priority countries. Among the countries in the LAC region, Paraguay’s experience establishing and strengthening a national CS committee serves as a success story for the improvement of reproductive health indicators in a context of increased country ownership. This brief documents the steps taken to ensure that in less than a decade, the CS Committee in Paraguay successfully fostered an enabling policy environment that led to increased financing and political commitment to making contraceptive supplies more easily available.

    This brief is based on the following report (only available in Spanish): Sistemitización de la Experiencia del Comité DAIA Paraguay.

  • Expanding access to health insurance is an important part of an overall strategy to achieve universal health coverage (UHC). Since its launch in 1999, the National Health Insurance Scheme (NHIS) has been Nigeria’s major initiative to expand health insurance in the country. To support this endeavor, the Health Policy Project conducted case studies of the experience of three countries—Colombia, India, and Thailand—as they developed government policies as a strategy to achieve universal health coverage (UHC). The lessons learned should be useful for Nigerian stakeholders involved in expanding and improving the NHIS, as well as for stakeholders in any country facing similar challenges. How health insurance expansion features in a UHC strategy depends on the resources available to the government via general taxation; the growth and maturity of private voluntary health insurance markets; and, most important, the state of the health system across primary, secondary, and tertiary healthcare. Our case studies suggest that pragmatic choices made by lower-middle and middle-income governments—a group where Nigeria may be placed—have involved hybrid health financing models.

  • La investigación tiene como objetivo principal analizar mediante cuadros y gráficos, el perfil socio demográfico, actitudes de las mujeres en edad fértil en el Perú, frente a la planificación familiar de acuerdo a su quintil de bienestar, así como la segmentación económica de las fuentes de métodos anticonceptivos, que permita la evaluación del programa de salud familiar.

  • La graduación de USAID fue un proceso planificado que permitió enfocar acciones hacia cuestiones estratégicas, sin embargo también se constituyó en una oportunidad de mejora y crecimiento que fue identificada por el gobierno de Paraguay y sustentada por su voluntad y compromiso político hacia la planificación familiar. Este documento recopila la experiencia del Comité para la Disponibilidad Asegurada de Insumos Anticonceptivos (DAIA) en Paraguay para comprender cómo su desempeño desembocó en resultados exitosos y describe cuáles fueron los factores clave y su interacción, para obtener tales resultados. Los logros alcanzados reforzaron la confianza de los integrantes del Comité DAIA y naturalmente trascendieron el ámbito de trabajo del mismo. Obteniendo el reconocimiento de las autoridades e incluso traspasando las fronteras, puesto que hoy en día el caso de Paraguay está considerado como un modelo para los demás países que impulsan la DAIA en la región.

    Un sumario de este informe en ingles, está disponible en: Promoting Country Ownership through Latin American Contraceptive Security Committees: Paraguay Case Study.

  • The United States Agency for International Development (USAID) supports the implementation of the United States President’s Emergency Plan for AIDS Relief (PEPFAR), a United States government (USG) initiative to save the lives of people around the world who are suffering from HIV and AIDS, in almost 100 countries. Since 2003, PEPFAR has worked with these countries to create systems that have stabilized the HIV epidemic by preventing new infections and providing care, support, and treatment to those infected and affected by HIV. Due to the progress that has been made in Guyana, the PEPFAR program will transition from a service delivery model to one that provides targeted technical assistance over the next five years (2013–2017). This will also result in a shift in USG funding, inclusive of USAID.

    Within this context, there is an identified need to clearly define roles and responsibilities for all key stakeholders and delineate next steps in the transition to ensure long-term sustainability of HIV prevention, care, and support services and the continuum of care for people infected and affected by HIV and AIDS.  Toward this effort, the USAID- and PEPFAR-funded Health Policy Project (HPP) supported PEPFAR Guyana by conducting a high-level assessment of HIV and AIDS NGOs, relevant private sector entities, the Ministry of Health (MOH), the National AIDS Program Secretariat (NAPS), and other relevant line ministries in Guyana. The aim of this assessment was to document the country’s capacity gaps and needs to support the transition of HIV services from donors to the country, and suggest approaches for ensuring an ethical transition and sustainability of these services over time.

  • In the Caribbean, transgender persons are disproportionately affected by HIV. Moreover, high levels of stigma and discrimination create significant barriers and make it difficult for them to access the health care services they need. Most clinicians in this region also do not receive any training on transgender health or broader issues of sexuality and diversity, further limiting availability of transgender-friendly services.

    In response, HPP has developed a training manual for healthcare workers in Jamaica, Barbados, and the Dominican Republic to strengthen their capacity to provide high-quality, stigma-free health services for transgender persons. This brief highlights key content from each of the chapters contained in the manual.