Welcome to the USAID-funded Health Policy Plus (HP+) project website.
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At the end of December 2021, the government of Guatemala issued a ministerial decree to create the Special Unit for Medical Emergencies (SUME), which will serve as a 911-like service to assist Guatemalans in medical emergencies. HEP+ worked with the Vice Minister of Hospitals and other departments within the Guatemalan Ministry of Health (MSPAS) to ensure the legal, technical, financial, and administrative elements for creating this unit were established and integrated efficiently. SUME will be available nationwide and contribute to MSPAS efficiency and service quality for COVID-19 patients during the pandemic, as well as support Guatemalans with other medical emergencies. This month, MSPAS will develop a timeline for SUME implementation and a manual to guide SUME operations and functions.
In Ouagadougou on September 25, 2021, 956 people received COVID-19 vaccines in one day, representing twice the daily average of people vaccinated in all the 88 vaccination sites in the Central Region since the start of Burkina Faso’s COVID-19 vaccine roll out. The mass vaccination event for adults was hosted by the U.S. Embassy in collaboration with the Ministry of Health and organized by HP+, which also managed transportation logistics for vaccine delivery, promoted participation through traditional and social media, and coordinated and supervised the team administering the vaccines. The vaccines administered were part of a shipment of 302,600 doses of the Johnson & Johnson vaccine provided by the U.S. Government, which supports immunization in Burkina Faso through the COVAX initiative and a bilateral partnership. This one-day event was a major boost to the country’s vaccination effort, which was launched on June 2, 2021. Prior to the event, only 2.4 percent of the country's targeted population was immunized. General Secretary of the Ministry of Health, Dr. Wilfried Ouedraogo, praised the initiative and support of the U.S. Government to mitigating the impact of COVID-19 in Burkina Faso.
Malawi is developing guidelines on how to sustain youth-friendly health services (YFHS) as evidence shows that the COVID-19 pandemic has drastically decreased the use of such care. The use of YFHS declined by approximately one-third in April/May of 2020 compared to the same period in 2019, according to two 2020 assessments on COVID-19 and YFHS. In response, HP+ Malawi is working with government and other stakeholders to develop National Guidelines for Sustaining Provision of Youth-Friendly Health Services amidst the COVID-19 Pandemic. The guidelines, which are being developed by a multisectoral group of stakeholders, are intended for both governmental and nongovernmental entities that offer health information and services to young people. They are a framework to hold implementers accountable for offering services during the pandemic as well as a way to empower communities and youth themselves to better understand their right to access health services despite COVID-19-related restrictions or access barriers. The government of Malawi is further discussing how to expand the scope of the guidelines to address public health emergencies beyond COVID-19.
Survey results from Kenya’s Busia, Kajiado, and Nairobi counties suggest that 38 percent of HIV clients are interested in collecting antiretroviral drug (ARV) refills from private pharmacies. Ninety-five percent of private pharmacy owners in these counties are also interested in extending current services to include dispensing refill ARVs to stable, adult clients. Clients’ willingness to pay a dispensing fee to collect ARVs from private pharmacies is well-aligned with the pharmacies’ minimum dispensing fee, suggesting that a decentralized distribution model involving a hub antiretroviral therapy site and private pharmacies for ARV pick-up may prove successful. HP+ is using these survey results to design and implement a community pharmacy ARV refill pick-up pilot in each county, intended to eventually transfer more than 1,000 clients to private pharmacies to obtain ARVs.
An analysis of Kenya’s national and county health budgets revealed that, while there has been a significant increase in resources allocated to health, gaps in implementation remain. HP+ conducted the study, which found that resources for health comprise just 9 percent of the total government budget; this falls short of the 15 percent recommended by the Abuja Declaration. Furthermore, county budgets continue to be dominated by recurrent expenditures—such as personnel salaries—raising concerns about resource allocation for effective and quality service delivery. The report provides evidence to support key recommendations for national and county governments to more effectively allocate resources to health.
Last month, more than 2,300 public and private sector health professionals in Guatemala participated in five hours of live training on COVID-19. The two sessions—broadcast on YouTube—featured presentations from top local experts and interactive questions from viewers. Since airing, more than 18,000 additional views have been recorded. In coordination with key health sector stakeholders, HEP+ facilitated and moderated the sessions and solicited participant input for future trainings. With a solid foundation of knowledge on the basics of COVID-19, health professionals nationwide will be able to improve practices in service delivery to support Guatemala’s pandemic response.
On July 30, an HP+ webinar, “Pivoting During COVID-19: How Health Policy Enables Service Provision in a Pandemic,” showcased the COVID-19 public health response underway in several countries, featuring ongoing service delivery activities in Brazil, El Salvador, and Honduras. Among the speakers were Mariella Ruiz-Rodriguez, an education development officer from USAID/Honduras. Evidence-based health policies allow countries to quickly and effectively pivot from business as usual to full-scale pandemic response. Longer-term strategies that ensure a continuum of care are likewise essential to support. The webinar considered what a holistic COVID-19 response looks like: focused on service delivery and informed by local realities.
HP+ analyzed how COVID-19 may disrupt health services in Burkina Faso, based on the level of face-to-face interaction with healthcare workers required to deliver interventions and the degree to which the interventions are time-sensitive or can be delayed without significant health impacts. Across the five health areas analyzed—family planning, maternal and child health, tuberculosis, HIV, and malaria—authors estimate that between 4,800 and 19,700 additional deaths could occur in 2020 alone as a result of disruptions from the pandemic. Burkina Faso is taking steps to maintain essential services and find ways to adjust service delivery models to mitigate these potential impacts.
A virtual satellite session—"Data Matters: The Role of Local Stakeholders and Data in Influencing HIV Services and Programs”—was held on July 8, as part of AIDS2020. The session showcased how HIV service delivery is improved when stakeholders generate and use local evidence and data to inform community-level programs. Representatives from the International Treatment Preparedness Coalition joined Palladium and HP+ colleagues Ron MacInnis and Ratna Soehoed, who discussed the use of province-level cost and epidemiological data for HIV planning and budgeting in Jakarta, Indonesia. A recording of the session will be available to the general public next week.
In Burkina Faso, one mayor has successfully mobilized more than US$124,100 to support the implementation of family planning activities under his jurisdiction. Following an HP+-supported sub-regional family planning workshop in 2018, Bobo-Dioulasso mayor Bourahima Fabéré Sanou committed to allocating 20 million CFAF (US$33,000) to family planning. Under his stewardship, the municipality mobilized an additional US$91,000 from the International Association of Francophone Mayors to support training and awareness-raising activities, contraceptive procurement, and the promotion of service delivery campaigns in secondary health and professional establishments. As a result of these activities demand for sexual and reproductive health services have increased 52 % in Bobo-Dioulasso, adding 1,335 users to the existing 2,578.
In December 2019, Madagascar integrated a tax exemption for contraceptives into the country’s finance law. The exemption, which will remove the 20% value-added tax applied at customs, followed HP+ support to the Ministry of Public Health’s Family Health Directorate to write advocacy messages encouraging key decisionmakers to make contraceptives tax-exempt. This exemption will reduce purchase costs, contributing to operationalization of the new Reproductive Health and Family Planning Law (2018) that promises access to contraceptives for all, and encourage private sector engagement in family planning service delivery.
The government of Mauritania, on International Women’s Day (March 8, 2018), signed a regulatory decree to implement a new reproductive health law in focus counties. The law was originally passed in January 2017. With the signing of this new regulatory guidance, there is now approval for community health workers to provide birth control pills and injectables. Nurses are now allowed to provide IUDs and implants. This policy advance, which promises to bring efficiency and scale to contraceptive use, comes as a result of advocacy efforts led by USAID and supported by the HP+, FP2020, AgirPF, Stop Sida, UNFPA, and local partners.
Supported by USAID's Health Policy Plus project, Kenya's parliamentary health committee adopted an amendment bill to the National Hospital Insurance Fund (NHIF) act. The proposed reforms impact delivery and financing of the mandated benefits package (inclusive of FP and HIV), supporting Kenya's efforts to achieve universal health coverage (UHC). The amendment will facilitate an increase in the number of individuals with health insurance, reducing out-of-pocket expenditure and ultimately reducing catastrophic health expenditure. If adopted, the bill will streamline administration at the NHIF, freeing up resources to be used for service delivery, contributing to domestic resource mobilization for health, and increasing access to essential health services. The bill now moves to the National Assembly for discussion and full adoption by September 2016.