Faith-based organizations are major providers of health services, especially in poor areas. Faith leaders have also traditionally been active towards mobilizing a global campaign for health financing. In addition, in health policy as in other areas, policy makers are confronted with a range of choices that can be informed by ethical and distributional analysis. This makes work on achieving the health MDGs important for DDVE. Our work in this area includes the following:
- Role of FBOs in health service delivery: DDVE is preparing country case studies in Africa on the role of FBOs in health systems. In Ghana for example, CHAG (Christian Health Association of Ghana) is a major service provider and data from recent household surveys as well as Ghana’s District Health Information System can be used to assess the comparative performance of public, private religious and private non-religious providers. In Rwanda, work is underway by the Africa Region on the analysis of the performance of various health service providers with a focus on the impact of the type of provider (public or private, with most private service providers being faith-based) and the type of contractual arrangement on performance.
- Benefit incidence analysis for public spending for health: Benefit incidence analysis is often used to assess who benefits from public services, but it is often conducted with imperfect data, and therefore with assumptions that can have a large impact on the results obtained. DDVE is working on an analysis of who benefits from public spending for health in several countries suggesting that not taking unit costs and needs properly into account can lead to serious bias in results. The unit is also doing comparative work on the performance of public, private non-religious and private religious providers in reaching the poor.
- Affordability of health services and impact of health policies: DDVE is analyzing data on the cost of health services for households, with a focus on affordability and a comparison of health spending for households who use public, private non-religious and private religious facilities. DDVE is also analyzing the impact of policies to reduce or eliminate health care fees. For example, a case study of the targeting performance of the elimination of fees for deliveries and services provided to children below five years of age is underway in Burundi. In Rwanda, DDVE is planning a new study to be able to evaluate the impact of new measures to make health insurance more affordable for the poor through the “mutuelles” system.
- Simulation tool: DDVE is building an Excel-based simulation tool to facilitate detailed demographic projections taking into account the effect of HIV/AIDS over time. Since the parameters of the model can be changed easily, the tool allows the user to compare the behavior of different population variables across different scenarios combining fertility, mortality and prevalence rates. The tool can be used to assess the costs and effects of different resource allocation policies. Using parameters on costs and impacts for different kinds of interventions, the user can either estimate the total cost and potential impact on HIV/AIDS variables of some pre specified intervention, or compute the funding required to reach pre specified coverage goals. A beta version of the tool was presented to World Bank staff working on HIV/AIDS in Africa in November 2008 as part of training activities carried under the Human Development Week at the World Bank (see Capacity Development - 2008).
- HIV-AIDS and malaria: DDVE is preparing a series of papers on HIV-AIDS and malaria to look at the effectiveness of various types of policy interventions. Examples include assessing the impact of bed nets on the incidence of fevers related to malaria in Burundi, and assessing the impact of information campaigns and other preventive measures on HIV/AIDS awareness in Burkina Faso. DDVE is also exploring collaborations with the ActAfrica team to conduct detailed country studies that will rely in part on the HIV-AIDS simulation tool mentioned above.
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