This report describes and evaluates the ways in which user-fees are currently implemented to finance public health services in Sub- Saharan Africa. It presents the main issues that arise in assessing cost recovery through user fees and evaluates experiences to date. The authors highlight variety of practices encountered in different countries, the too common failure to structure charges so as to promote efficient use, and the lack of effective exemption structures for protecting the poor. The study thoroughly reviews standard cost recovery models and describes an initiative launched in Bamako, Mali, in 1987. Issues, experience, and conclusions are drawn from a sample of 38 countries.
This scholarly book focuses on stroke in Africa. Stroke is a leading cause of disability among adults of all ages, contributing significantly to health care costs related to long term implications, particularly if rehabilitation is sub-optimal. Given the burden of stroke in Africa, there is a need for a book that focuses on functioning African stroke survivors and the implications for rehabilitation within the African context. In addition, there is a need to progress with contextualised, person-centred, evidence-based guidance for the rehabilitation of people with stroke in Africa, thereby enabling them to lead socially and economically meaningful lives. The research incorporated in the book used a range of primary and secondary methodological approaches (scoping reviews, systematic reviews, meta-analyses, descriptive studies, surveys, health economics, and clinical practice guideline methodology) to shed new insights into African-centred issues and strategies to optimise function post-stroke.
This book focuses on Africa’s challenges, achievements, and failures over the past several centuries using an interdisciplinary approach that combines theory and fact and evidence-based practices and interventions in public health, and argues that most of the health problems in Africa are not a result of scarce or lack of resources, but of the misconceived and misplaced priorities that have left the continent behind every other on the globe in terms of health, education, and equitable distribution of opportunities and access to (quality) health as agreed by the United Nations member states at Alma-Ata in 1978.
The objective in this paper is to estimate the economic costs of COVID-19 policies and external shocks in a developing country context, with a focus on agri-food system impacts. Ghana is selected as a case study. Ghana recorded its first two cases of COVID-19 infection on 12 March 2020. The government responded by gradually introducing social distancing measures, travel restrictions, border closures, and eventually a partial, two-week “partial” lockdown in the country’s largest metropolitan areas of Accra and Kumasi. Social distancing measures have been enforced nationwide and include bans on conferences, workshops, and sporting and religious events, as well as the closure of bars and nightclubs. All educational institutions are also closed. The partial lockdown measures in urban areas directed all residents to remain home except for essential business, prohibited non-essential inter-city travel and transport, and only essential manufacturing and services operations were permitted to continue (The Presidency 2020). At the time the lockdown was announced, Ghana’s Ministry of Finance revised its GDP growth estimate for 2020 downwards from 6.8 to 1.5 percent (MoF 2020), although the Minister warned that growth could fall further if lockdown measures were extended. The lockdown was initially extended for a third week but was officially lifted on 20 April. Social distancing measures remain in place nationwide, although a gradual easing of restrictions commenced in June. Ghana’s borders remain closed at the time of writing.
This report discusses several different approaches that support reforming health care services in developing countries. For some time now, health care services have been supported by government funds. As demands for improving health care services continue to increase additional demands will be placed on governments to respond. This, however, will not be easy. Slow economic growth and record budget deficits in the 1980's have forced reductions in public spending. Alternative approaches to finance health care services are needed. Such possible changes could involve: decentralization of federal government involvement; the promotion of nongovernment involvement; the imposition of user fees; and, establishing health insurance. Finally, the role of the Bank in pursuing new financing strategies is discussed.
Spanish edition. World Bank Technical Paper No. 345S. This report examines specific policies for achieving sustainable development of the mining industry in the countries of Latin America and the Caribbean. The report highlights the importance of the mining sector to national economies of the region and discusses World Bank assistance in formulating policy. Also available in English: (ISBN 0-8213-3816-1) Stock no. 13816.
Sustainable infrastructure development is vital for Africa s prosperity. And now is the time to begin the transformation. This volume is the culmination of an unprecedented effort to document, analyze, and interpret the full extent of the challenge in developing Sub-Saharan Africa s infrastructure sectors. As a result, it represents the most comprehensive reference currently available on infrastructure in the region. The book covers the five main economic infrastructure sectors information and communication technology, irrigation, power, transport, and water and sanitation. 'Africa s Infrastructure: A Time for Transformation' reflects the collaboration of a wide array of African regional institutions and development partners under the auspices of the Infrastructure Consortium for Africa. It presents the findings of the Africa Infrastructure Country Diagnostic (AICD), a project launched following a commitment in 2005 by the international community (after the G8 summit at Gleneagles, Scotland) to scale up financial support for infrastructure development in Africa. The lack of reliable information in this area made it difficult to evaluate the success of past interventions, prioritize current allocations, and provide benchmarks for measuring future progress, hence the need for the AICD. Africa s infrastructure sectors lag well behind those of the rest of the world, and the gap is widening. Some of the main policy-relevant findings highlighted in the book include the following: infrastructure in the region is exceptionally expensive, with tariffs being many times higher than those found elsewhere. Inadequate and expensive infrastructure is retarding growth by 2 percentage points each year. Solving the problem will cost over US$90 billion per year, which is more than twice what is being spent in Africa today. However, money alone is not the answer. Prudent policies, wise management, and sound maintenance can improve efficiency, thereby stretching the infrastructure dollar. There is the potential to recover an additional US$17 billion a year from within the existing infrastructure resource envelope simply by improving efficiency. For example, improved revenue collection and utility management could generate US$3.3 billion per year. Regional power trade could reduce annual costs by US$2 billion. And deregulating the trucking industry could reduce freight costs by one-half. So, raising more funds without also tackling inefficiencies would be like pouring water into a leaking bucket. Finally, the power sector and fragile states represent particular challenges. Even if every efficiency in every infrastructure sector could be captured, a substantial funding gap of $31 billion a year would remain. Nevertheless, the African people and economies cannot wait any longer. Now is the time to begin the transformation to sustainable development.
This book provides in-depth descriptions and analysis of how cash transfer programs have evolved and been used in Sub-Saharan Africa since 2000. The analysis focuses on program features and implementation, but it also highlights political economy issues and current knowledge gaps.
This study seeks to demonstrate the impact of cost sharing on the population of Yemen and specifically on poor and vulnerable people. It aims to alert decision makers to features of cost-sharing policies that are likely to hamper equitable access to services and prevent quality improvements and sustainability.
