DOCSLIB.ORG

Econometric Estimation of WHO-CHOICE Country-Specific Costs for Inpatient and Outpatient Health Service Delivery

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Econometric Estimation of WHO-CHOICE Country-Specific Costs for Inpatient and Outpatient Health Service Delivery Stenberg et al. Cost Ef Resour Alloc (2018) 16:11 https://doi.org/10.1186/s12962-018-0095-x Cost Effectiveness and Resource Allocation RESEARCH Open Access Econometric estimation of WHO‑CHOICE country‑specifc costs for inpatient and outpatient health service delivery Karin Stenberg1* , Jeremy A. Lauer1, Georgios Gkountouras2, Christopher Fitzpatrick3 and Anderson Stanciole4 Abstract Background: Policy makers require information on costs related to inpatient and outpatient health services to inform resource allocation decisions. Methods: Country data sets were gathered in 2008–2010 through literature reviews, website searches and a public call for cost data. Multivariate regression analysis was used to explore the determinants of variability in unit costs using data from 30 countries. Two models were designed, with the inpatient and outpatient models drawing upon 3407 and 9028 observations respectively. Cost estimates are produced at country and regional level, with 95% conf- dence intervals. Results: Inpatient costs across 30 countries are signifcantly associated with the type of hospital, ownership, as well as bed occupancy rate, average length of stay, and total number of inpatient admissions. Changes in outpatient costs are signifcantly associated with location, facility ownership and the level of care, as well as to the number of outpa- tient visits and visits per provider per day. Conclusions: These updated WHO-CHOICE service delivery unit costs are statistically robust and may be used by analysts as inputs for economic analysis. The models can predict country-specifc unit costs at diferent capacity levels and in diferent settings. Keywords: Cost, Regression analysis, Estimates, Inpatient, Outpatient Background [1]. Having access to accurate and reliable information Health planners concerned with evidence-informed deci- on the cost of health services can serve various purposes sion making and resource allocation rely on high quality including discussions on afordability and fnancial sus- information regarding the resources needed to imple- tainability, budgeting, cost-efectiveness and cost–beneft ment investment strategies, and comparing these against analysis [2]. current and future budgetary constraints. Information on Literature related to estimates on the so-called ‘unit costs is essential to inform discussions around value for costs’ of specifc health interventions is a growing feld, money and efciency. Unfortunately cost data is sparse yet the transferability of such fndings from one setting to in many settings, especially in low- and middle income another is limited [2, 3]. For example, the Access, Bottle- countries, where ambitious health targets are now being necks, Costs and Equity (ABCE) initiative from the Uni- set for the 2030 Sustainable Development Goals (SDGs). versity of Washington’s Institute for Health Metrics and Challenges include insufcient allocation and/or inef- Evaluation has been collecting primary data on health fcient allocation of resources towards health priorities care facility costs. However, the focus has been limited to Ghana, Kenya, Uganda and Zambia and there is no *Correspondence: [email protected] intention to create generalized global estimates [4–7]. 1 Department of Health Systems Governance and Financing, World Similarly, the recently established Global Health Cost Health Organization, Geneva, Switzerland Full list of author information is available at the end of the article Consortium at the University of Washington (https:// © The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Stenberg et al. Cost Ef Resour Alloc (2018) 16:11 Page 2 of 15 ghcosting.org/) intends to produce unit cost estimates assumptions. Inputs into the service production process that can be adapted to local settings, but its scope is lim- (including technology, prices and production efciency) ited to TB and HIV services, and will not provide cost change over time, and WHO-CHOICE seeks to regularly estimates for general inpatient or outpatient care. provide updated estimates. WHO-CHOICE estimates To our knowledge, the WHO-CHOICE (CHOosing are particularly useful for low- and middle income coun- Interventions that are Cost Efective) project is the only tries that may not have such data readily available. programme seeking to collect and standardise estimates In this paper we describe a process whereby country of the costs related to facility-based service delivery, to data sets were gathered and multivariate regression anal- compare these across countries, and to provide country- ysis was used to explore the determinants of variability in specifc estimates of facility service costs as a global pub- unit costs, in order to produce updated WHO-CHOICE lic good. WHO-CHOICE estimates are produced for all estimates. countries and can therefore be used in settings where no Te previous round of WHO-CHOICE results for local data is available. Estimates are based on modeling facility cost are henceforth referred to as “the frst round of primary and secondary data, and are derived from a analysis” [3, 8, 9]. Estimates are publicly available (http:// model that provides the best ft according to global data. www.who.int/choice) and have been widely used by Such models will not yield perfect predictions for all researchers, academics and analysts at both global and countries, and it is therefore maintained that whenever country level [10, 11]—for example publications see good quality country unit cost data is available from a http://who.int/choice/documents/en/). representative sample, this should be used rather than using the CHOICE predictions. Methods Under WHO-CHOICE, WHO has collated facility cost Te “Methods” section frst describes the data collection data from countries since 2000. Tese data have served process followed by the econometric analysis. to inform estimates for country-specifc costs related to health service utilization—with estimates for cost per inpa- Data collection tient day and outpatient visit. Te service delivery unit cost As a frst step a literature review was undertaken with the estimates are used to support cost-efectiveness analysis aim of identifying variables and methods that should be within the WHO-CHOICE project, among other things. taken into account during data collection and analysis [12]. • Inpatient day Te estimated cost of a hospital bed- Experience from prior work suggested that on the day refects only the “hotel” component of the hospital ground ‘bottom-up’ facility-level estimation is not a cost- cost—i.e. it excludes the cost of drugs and diagnostic efective approach for producing large data sets, given tests but includes costs such as personnel, capital infra- the large costs involved with primary data collection. structure and equipment, laboratory, maintenance and Instead we made use of existing data for secondary anal- other operational costs of the hospital, as well as food ysis. Cost data were gathered 2009–2010 through three costs. Te intent is to produce a measure that covers mechanisms: those components that are assumed to be standardised across diferent diseases and treatments. a. Authors identifed through the literature review were • Outpatient visit Similarly, WHO-CHOICE outpatient directly contacted; costs include components not specifc to the disease b. A public call went out for cost data; and or treatment, but those largely assumed to be stand- c. Websites of public institutions were searched for ardised across disease conditions for which the care is publicly available data. provided: namely personnel, capital infrastructure and equipment, laboratory, maintenance and other opera- Te majority of data was gathered from respondents tional costs of the health facility. In recognition of the to the public call. Most of the sources identifed through fact that costs for equipment, maintenance etc., may the literature review did not report facility-specifc unit vary depending on the setting in which care is pro- costs estimates, but instead presented only the sample vided, inpatient and outpatient care costs are estimated average. Terefore, data from only two studies identifed for diferent types of providers and levels of the health though the literature review were ultimately included in system. the estimation dataset (Additional fle 1: Annex S1). In- depth examination of available online public data bases Te use of standardised estimates for the service deliv- revealed limited usefulness of such data as they gener- ery component of intervention costs ensures that inter- ally lacked several of the variables required to inform the ventions can be compared fairly, using consistent price Stenberg et al. Cost Ef Resour Alloc (2018) 16:11 Page 3 of 15 analysis. Only one database found on-line was considered Respondents’ fles were screened for data quality useful for extracting data [13]. and consistency with the requested data format. Unit Te public call for cost data was released and widely costs were extracted from the data fles. Quality
Load more

Recommended publications
  • Stakeholders' Perceptions of Policy Options to Support the Integration Of
    Ajuebor et al. Human Resources for Health (2019) 17:13 https://doi.org/10.1186/s12960-019-0348-6 RESEARCH Open Access Stakeholders’ perceptions of policy options to support the integration of community health workers in health systems Onyema Ajuebor1* , Giorgio Cometto1, Mathieu Boniol1 and Elie A. Akl2 Abstract Background: Community health workers (CHWs) are an important component of the health workforce in many countries. The World Health Organization (WHO) has developed a guideline to support the integration of CHWs into health systems. This study assesses stakeholders’ valuation of outcomes of interest, acceptability and feasibility of policy options considered for the CHW guideline development. Methods: A cross-sectional mixed methods (quantitative and qualitative) study targeting stakeholders involved directly or indirectly in country implementation of CHW programmes was conducted in 2017. Data was collected from 96 stakeholders from five WHO regions using an online questionnaire. A Likert scale (1 to 9) was used to grade participants’ assessments of the outcomes of interest, and the acceptability and feasibility of policy options were considered. Results: All outcomes of interest were considered by at least 90% of participants as ‘important’ or ‘critical’. Most critical outcomes were ‘improved quality of CHW health services’ and ‘increased health service coverage’ (91.5% and 86.2% participants judging them as ‘critical’ respectively). Out of 40 policy options, 35 were considered as ‘definitely acceptable’ and 36 ‘definitely feasible’ by most participants. The least acceptable option (37% of participants rating ‘definitely not acceptable’) was the selection of candidates based on age. The least feasible option (29% of participants rating ‘definitely not feasible’) was the selection of CHWs with a minimum of secondary education.
    [Show full text]
  • Towards a Framework Convention on Global Health: a Transformative Agenda for Global Health Justice
    Yale Journal of Health Policy, Law, and Ethics Volume 13 Issue 1 Article 1 2013 Towards a Framework Convention on Global Health: A Transformative Agenda for Global Health Justice Lawrence 0. Gostin Eric A. Friedman Follow this and additional works at: https://digitalcommons.law.yale.edu/yjhple Part of the Health Law and Policy Commons, and the Legal Ethics and Professional Responsibility Commons Recommended Citation Lawrence 0. Gostin & Eric A. Friedman, Towards a Framework Convention on Global Health: A Transformative Agenda for Global Health Justice, 13 YALE J. HEALTH POL'Y L. & ETHICS (2013). Available at: https://digitalcommons.law.yale.edu/yjhple/vol13/iss1/1 This Article is brought to you for free and open access by Yale Law School Legal Scholarship Repository. It has been accepted for inclusion in Yale Journal of Health Policy, Law, and Ethics by an authorized editor of Yale Law School Legal Scholarship Repository. For more information, please contact [email protected]. Gostin and Friedman: Towards a Framework Convention on Global Health: ARTICLESA Transformative Towards a Framework Convention on Global Health: A Transformative Agenda for Global Health Justice t Lawrence 0. Gostin* & Eric A. Friedman" ABSTRACT: Global health inequities cause nearly 20 million deaths annually, mostly among the world's poor. Yet international law currently does little to reduce the massive inequalities that underlie these deaths. This Article offers the first systematic account of the goals and justifications, normative foundations, and potential construction of a proposed new global health treaty, a Framework Convention on Global Health (FCGH), grounded in the human right to health.
    [Show full text]
  • Tracking Universal Health Coverage: 2017 Global Monitoring Report Tracking Universal Health Coverage: 2017 Global Monitoring Report
    Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized ISBN 978 92 4 151355 5 http://www.who.int/healthinfo/universal_health_coverage/report/2017/en/ Public Disclosure Authorized Tracking Universal Health Coverage: http://www.worldbank.org/health 2017 Global Monitoring Report Tracking Universal Health Coverage: 2017 Global Monitoring Report Tracking universal health coverage: 2017 global monitoring report ISBN 978-92-4-151355-5 © World Health Organization and the International Bank for Reconstruction and Development / The World Bank 2017 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https:// creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO or The World Bank endorse any specic organization, products or services. The use of the WHO logo or The World Bank logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO) or The World Bank. WHO and The World Bank are not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization.
    [Show full text]
  • World Report on Health Policy and Systems Research
    World report on health policy and systems research ISBN 978-92-4-151226-8 © World Health Organization 2017 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. World report on health policy and systems research. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing.
    [Show full text]
  • The World Health Organization and the Globalization of Chronic Noncommunicable Disease
    1 The World Health Organization and the Globalization of Chronic Noncommunicable Disease George Weisz, PhD, McGill University Etienne Vignola-Gagné, Dr. Phil., McGill University George Weisz is Cotton-Hannah Professor of the History of Medicine at McGill University. Etienne Vignola-Gagné is a Postdoctoral Fellow at McGill University This is an early draft of an article that has subsequently been published in Population and Development Review. Complete citation information for the final version of the paper, as published in the print edition of Population and Development Review, is available on Wiley Interscience’s online journal service, accessible via the journal’s website at http://www.blackwellpublishing.com/pdr.” 2 Abstract Chronic noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs) have recently provoked a surge of public interest. This paper examines the policy literature, notably the archives and publications of the World Health Organization (WHO), which has dominated this field, to analyze the emergence and consolidation of this new agenda. Starting with programs to control cardiovascular disease in the 1970s, experts from eastern and western Europe had by the late 1980s consolidated a program for the prevention of NCDs risk factors at the WHO. NCDs remained a relatively minor concern until the collaboration of World Bank health economists with WHO epidemiologists lead to the Global Burden of Disease study that provided an “evidentiary breakthrough” for NCD activism by quantifying the extent of the problem. Soon after, WHO itself, facing severe criticism, underwent major reform. NDC advocacy contributed to revitalizing the WHO’s normative and coordinative functions. By leading a growing advocacy coalition, within which The Lancet played a key role, WHO established itself as a leading institution in this domain.
    [Show full text]
  • The Mistreatment of Women During Childbirth in Health Facilities Globally: a Mixed-Methods Systematic Review
    RESEARCH ARTICLE The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review Meghan A. Bohren1,2*, Joshua P. Vogel2, Erin C. Hunter3, Olha Lutsiv4, Suprita K. Makh5, João Paulo Souza6, Carolina Aguiar1, Fernando Saraiva Coneglian6, Alex Luíz Araújo Diniz6, Özge Tunçalp2, Dena Javadi3, Olufemi T. Oladapo2, Rajat Khosla2, Michelle J. Hindin1,2, A. Metin Gülmezoglu2 1 Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America, 2 Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland, 3 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America, 4 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada, 5 Population Services International, Washington, D. C., United States of America, 6 Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil OPEN ACCESS * [email protected] Citation: Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. (2015) The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review. PLoS Abstract Med 12(6): e1001847. doi:10.1371/journal. pmed.1001847 Academic Editor: Rachel Jewkes, Medical Research Council, SOUTH AFRICA Background Received: November 18, 2014 Despite growing recognition of neglectful, abusive, and disrespectful treatment of women Accepted: May 22, 2015 during childbirth in health facilities, there is no consensus at a global level on how these occurrences are defined and measured.
    [Show full text]
  • World Health Organization
    E1 | World Health Organization The strategic importance of the WHO as the UN’s specialist health agency, its many influential programmes and policies at global, regional and national and community levels, and perhaps above all, its humanitarian mission, earn it worldwide authority and guarantee it a central place in this report. While it may be seen as the leading global health organization, it does not have the greatest impact on health. As many sections of this report illustrate, transnational corporations and other global institutions – particularly the World Bank and International Monetary Fund – have a growing influence on population health that outweighs WHO’s. Furthermore, some of these institu- tions, the Bank in particular, now operate in direct competition with WHO as the leading influence on health sector policy. The rise of neoliberal economics and the accompanying attacks on multilateralism led by the US have created a new, difficult context for WHO’s work to which the organization, starved of resources and sometimes poorly led and managed, is failing to find an effec- tive response. The purpose of this chapter is to explore this decline in WHO’s fortunes from the perspective of a critical friend, and suggest how it might begin to be reversed. The problems of global health and global health governance are be- yond the reach of any entity working in isolation, requiring WHO leaders and staff, governments, health professionals and civil society to work together in new alliances. A new shared vision of WHO for the 21st century must draw on its strengths, but be reshaped for the modern world, as part of a broader vision of global governance.
    [Show full text]
  • Comparing Performance of Universal Health Care Countries, 2020
    2020 Comparing Performance of Universal Health Care Countries, 2020 Bacchus Barua and Mackenzie Moir 2020 • Fraser Institute Comparing Performance of Universal Health Care Countries, 2020 by Bacchus Barua and Mackenzie Moir Contents Executive Summary / i Introduction / 1 1. Method / 2 2. How much does Canada spend on health care compared to other countries? / 8 3. How well does Canada’s health-care system perform? / 11 4 Health status and outcomes / 34 Conclusion / 40 Appendix—additional tables and data / 41 References / 50 About the Authors / 55 Acknowledgments / 56 Publishing Information / 57 Purpose, Funding, and Independence / 58 Supporting the Fraser Institute / 58 About the Fraser Institute / 59 Editorial Advisory Board / 60 Comparing Performance of Universal Health Care Countries, 2020 • Barua and Moir • i Executive Summary Comparing the performance of different countries’ health-care systems provides an opportunity for policy makers and the general public to determine how well Canada’s health-care system is performing relative to its international peers. Overall, the data examined suggest that, although Canada’s is among the most expensive universal-access health-care systems in the OECD, its performance is modest to poor. This study uses a “value for money approach” to compare the cost and performance of 28 universal health-care systems in high-income countries. The level of health-care expenditure is measured using two indicators, while the performance of each country’s health-care system is measured using 43 indi- cators, representing the four broad categories: [1] availability of resources [2] use of resources [3] access to resources [4] quality and clinical performance. This year’s report includes one new resource indicator (long-term care bed availability) and two new patient safety indicators: post-operative wound dehis- cence; and post-operative sepsis after abdominal surgery.
    [Show full text]
  • The Changing Global Context of Public Health
    PUBLIC HEALTH Public health The changing global context of public health A J McMichael, R Beaglehole Future health prospects depend increasingly on globalisation processes and on the impact of global environmental change. Economic globalisation—entailing deregulated trade and investment—is a mixed blessing for health. Economic growth and the dissemination of technologies have widely enhanced life expectancy. However, aspects of globalisation are jeopardising health by eroding social and environmental conditions, exacerbating the rich-poor gap, and disseminating consumerism. Global environmental changes reflect the growth of populations and the intensity of economic activity. These changes include altered composition of the atmosphere, land degradation, depletion of terrestrial aquifers and ocean fisheries, and loss of biodiversity. This weakening of life-supporting systems poses health risks. Contemporary public health must therefore encompass the interrelated tasks of reducing social and health inequalities and achieving health-sustaining environments. We are living through what is, historically, a major recognition of the importance of two fundamental transition in the health of populations. There have been dimensions to this public-health task. First, because social broad gains in life expectancy during the past half-century. and material inequalities within a society generate health Fertility rates are declining. The profile of major causes of inequalities, an important task is to elucidate, through death and disease is being transformed; the pattern of research, the underlying determinants of these health infectious diseases has become much more labile (and inequalities.4 That knowledge must then be applied, in part antimicrobial resistance is rising widely); and health through professional practice, to the development of inequalities between rich and poor persist.
    [Show full text]
  • 10 0 0 0 O F T Hese Women and 2 0 0 0 0 0 O F T Heir in F an T S Die a S a Resul T O F Childbirt H; 5 2 9 0 0 0 Die E Ach Ye a R
    The World Health Report World Health Day 2005 Make every mother and child count World Health Organization Facts and figures from The World Health Report 2005 “Public health programmes need to work together so that all families have access to a continuum of care that extends from pregnancy (and even before), through childbirth, and on into childhood, instead of the often fragmented services available at present”. Dr LEE Jong-wook, Director-General, WHO THE GLOBAL PICTURE PREGNANCY Pregnancy and childbirth and their consequences are still the A substantial proportion of maternal deaths – perhaps as many as leading causes of death, disease and disability among women of one in four – occur during pregnancy. reproductive age in developing countries. Each year, approximately 50 million women living in malaria- Over 300 million women in the developing world suffer from endemic countries throughout the world become pregnant. Around short-term or long-term illness brought about by pregnancy and 10 000 of these women and 200 000 of their infants die as a result of childbirth; 529 000 die each year. malaria infection. Maternal mortality is highest by far in Africa, where the lifetime Of the estimated 211 million pregnancies that occur every year, risk of maternal death is 1 in 16, compared with 1 in 2800 in rich about 46 million end in induced abortion, of which only approximately countries. 60% are carried out under safe conditions. More than 50% of all child deaths occur in just six countries: More than 18 million induced abortions each year are performed China, the Democratic Republic of the Congo, Ethiopia, India, Nigeria and by people lacking the necessary skills or in an environment lacking the Pakistan.
    [Show full text]
  • Improving Pandemic Preparedness: Lessons from COVID-19
    Independent Task Force Report No. 78 Improving Pandemic Preparedness Lessons From COVID-19 Sylvia Mathews Burwell and Frances Fragos Townsend, Chairs Thomas J. Bollyky and Stewart M. Patrick, Project Directors Independent Task Force Report No. 78 Improving Pandemic Preparedness Lessons From COVID-19 Sylvia Mathews Burwell and Frances Fragos Townsend, Chairs Thomas J. Bollyky and Stewart M. Patrick, Project Directors The Council on Foreign Relations (CFR) is an independent, nonpartisan membership organization, think tank, and publisher dedicated to being a resource for its members, government officials, business executives, journalists, educators and students, civic and religious leaders, and other interested citizens in order to help them better understand the world and the foreign policy choices facing the United States and other countries. Founded in 1921, CFR carries out its mission by maintaining a diverse membership, with special programs to promote interest and develop expertise in the next generation of foreign policy leaders; convening meetings at its headquarters in New York and in Washington, DC, and other cities where senior government officials, members of Congress, global leaders, and prominent thinkers come together with Council members to discuss and debate major international issues; supporting a Studies Program that fosters independent research, enabling CFR scholars to produce articles, reports, and books and hold roundtables that analyze foreign policy issues and make concrete policy recommendations; publishing Foreign Affairs, the preeminent journal on international affairs and U.S. foreign policy; sponsoring Independent Task Forces that produce reports with both findings and policy prescriptions on the most important foreign policy topics; and providing up-to- date information and analysis about world events and American foreign policy on its website, CFR.org.
    [Show full text]
  • 50 Years of Global Health: Saving Lives and Building Futures
    50 Years of Global Health Saving Lives and Building Futures Sources for the images used in the photo collage: U.S. Agency for International Development Millennium Challenge Corporation Abt Associates Catholic Relief Services The Haitian Health Foundation Helen Keller International Program for Appropriate Technology in Health University Research Corporation Dana Allen Franklin Baer Luis Benavente Judith Brown Gary Cook Sara Fajardo Jessica Hartl Kendra Helmer Liz Nugent 50 Years of Global Health Saving Lives and Building Futures By Tonya Himelfarb 50 Years of Global Health Years 50 ii Acknowledgments While this document is the result of collaboration and support from many people, special thanks go to the following: ■ Robert Clay, Bureau for Global Health, Deputy Assistant Administrator, who conceived of the idea of docu- menting USAID’s global health legacy, provided technical guidance and made this project happen. ■ Khadijat Mojidi, Bureau for Global Health, Health Officer, who coordinated the process with unfailing enthusi- asm, rigor and sound advice. ■ The Health History Project Advisory Committee, made up of Robert Clay and Khadijat Mojidi, Office of the Assistant Administrator, Bureau for Global Health; Elise Ayers, Office of Country Support; Lisa Baldwin, Africa Bureau; Karen Cavanaugh and Bob Emery, Office of Health Systems; Gary Cook, Asia and Middle East Bureau; Paul Holmes, Europe and Eurasia Bureau; Kelly Saldana and Dale Gibb, Office of Health, Infectious Diseases and Nutrition; Lindsey Kirn, Bureau for Global Health, Communications; Jane Silcock, Office of Population and Reproductive Health; Lindsay Stewart, Latin America and Caribbean Bureau; David Stanton, Office of HIV/AIDS; and Richard Whitaker, Office of Policy, Programs and Planning, who reviewed drafts, made suggestions, located background materials and provided quality control and accuracy.
    [Show full text]