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Aid Fragmentation or Aid Pluralism? The Effect of Multiple Donors on Child Survival in Developing Countries, 1990–2010

While most policy-makers and researchers stress the negative impact of “aid fragmentation” on development outcomes in recipient countries, we argue that the greater diversity of perspectives entailed by higher multiplicity of donors can help select better policies. We hypothesize a U-shaped relationship: countries with a moderate number of donors fare better than countries with either […]
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Competent and defcient provision of childbirth services: a descriptive observational study assessing the quality of intrapartum care in two provinces of the Democratic Republic of the Congo

Background: A majority of women in the Democratic Republic of the Congo (DRC) give birth in a health facility, but maternal and newborn mortality remains high. In rural areas, the quality of facility-based delivery care is often low. This study examines clinical quality of intrapartum care in two provinces of the DRC. Methods: We observed […]
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If You Build It, They Will Come? Lessons on Barriers to Service Use at PBF Facilities in Nigeria

Results-based financing (RBF) has been used to great effect to improve the efficiency and quality of health facilities across the developing world. These improvements, however, do not always reach the most vulnerable and marginalized households; they continue to face a variety of barriers in accessing the services offered at RBF health facilities. This has been […]
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Performance-based Financing versus “Unconditional” Direct Facility Financing - False Dichotomy?

By Sophie Witter, Maria Paola Bertone, Karin Diaconu, and Olga Bornemisza A debate about how best to finance essential health care in low- and middle-income settings has been running for decades, with public health systems often failing to provide reliable and adequate funding for primary health care in particular. Since 2000, many have advocated and experimented with performance-based financing as […]
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Compensation models for community health workers: Comparison of legal frameworks across five countries

The five countries profiled represent possible archetypes for CHW compensation: Brazil (public), Ghana (volunteer-based), Nigeria (private), Rwanda (cooperatives with performance based incentives) and South Africa (hybrid public/private). Advantages and disadvantages of each model with respect to (i) CHWs, in terms of financial protection, and (ii) the health system, in terms of ease of implementation, are […]
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Community health volunteers could help improve access to and use of essential health services by communities in LMICs: an umbrella review

A number of primary studies and systematic reviews focused on the contribution of community health workers (CHWs) in the delivery of essential health services. In many countries, a cadre of informal health workers also provide services on a volunteer basis [community health volunteers (CHV)], but there has been no synthesis of studies investigating their role […]
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What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers

We identified 122 reviews (75 systematic reviews, of which 34 are meta-analyses, and 47 non-systematic reviews). Eighty-three of the included reviews were from low- and middle-income countries, 29 were from high-income countries, and 10 were global. CHW programs included in these reviews are diverse in interventions provided, selection and training of CHWs, supervision, remuneration, and […]
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