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Khalid F, Afzal S, Shirazi A, Quick I, Mataria A. Coordinating external assistance for UHC: Pakistan's early experience of the SDG3 GAP. Health Policy Plan 2024; 39:247-251. [PMID: 37978855 PMCID: PMC11020300 DOI: 10.1093/heapol/czad105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 09/15/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023] Open
Abstract
Pakistan is a lower middle-income setting. External assistance for health and development partners play an important role in health sector development. The federal system and health care delivery as a devolved provincial subject warrant regular and effective coordination among federating units and partners. Pakistan was selected as a priority country in 2019 for the implementation of the Global Action Plan for Healthy Lives and Well-being for All (SDG3 GAP). Given the ongoing universal health coverage (UHC) reforms, the country prioritized two SDG3 GAP accelerators, related to primary health care (PHC) and sustainable financing for health (SFH). Eight partner agencies representing PHC and SFH accelerators jointly planned and conducted a 'PHC for UHC mission' to Pakistan in 2021. This mission paved the way for setting up an SDG3 GAP Coordination Committee and a 'PHC Service Delivery and Financing working group', which have been regularly coming together through in-person and virtual meetings; the latter was relatively uncommon previously and this new way of working provided a chance to build rapport, share workplans, identify duplications in technical assistance and jointly gauge governments' priorities. This has shifted the focus of reforms deliberations from 'what' to 'how', enabling joint strategic planning and implementation. The joint work by SDG3 GAP partners with the Ministry of National Health Services Regulation & Coordination linked discussions on health financing and service delivery reforms for the first time, and has contributed to advocacy, analysis, strategic policy dialogue, institutional strengthening and implementation of UHC reforms, with a focus on PHC. Even though joint work by SDG3 GAP partners undoubtedly shows the potential for better alignment and collaboration, translation of the commitment to better collaboration into concrete impact has been the result of committed and engaged staff members, rather than institutionalized change, which will require strong incentives for collaboration.
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Affiliation(s)
- Faraz Khalid
- Universal Health Coverage/Health Systems, World Health Organization , Regional Office for the Eastern Mediterranean, Monazamet El Seha El Alamia Street Extension of Abdel Razak El Sanhouri Street, Nasr City, Cairo 7608, Egypt
| | - Sabeen Afzal
- Health Wing, Ministry of National Health Services, Regulation and Coordination, Pakistan Secretariat, Islamabad 44020, Pakistan
| | - Ali Shirazi
- Health Systems Cluster, World Health Organization, Pakistan Country Office, Park Road, Chak Shahzad, Islamabad 45500, Pakistan
| | - Isadora Quick
- Secretariat of the Global Action Plan for Healthy Lives and Well-being for All, Office of the Director-General, World Health Organization Headquarters, Avenue Appia 20, Geneva 1211, Switzerland
| | - Awad Mataria
- Universal Health Coverage/Health Systems, World Health Organization , Regional Office for the Eastern Mediterranean, Monazamet El Seha El Alamia Street Extension of Abdel Razak El Sanhouri Street, Nasr City, Cairo 7608, Egypt
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Buisson Y, Guyon P, Buisson Y, Osinki N, Tamames C, Leconte J, Jarry M, Robert J, Dumurgier C, Choua O, Ahmat MO, Moussa KM, Sabe D, Telniaret A, Rabo AM, Kitoko N, Allatombaye B, Bunn D, Hong Dao N, Huy LD, Bich Ngoc HL, Tram LH, Van Khoi T, Van Thuc P, Van Linh P, Kourouma K, Gerald FT, Kourouma K, Saibou PO, Ngunyi GC, Wombe B, Alessandroni P, Andrei R, Delmont J, Gasiglia C, Haï VV, Heng M, Heng T, Khampho C, Mekhalfa D, Marcaggi S, Pimontipa M, Plotton JR, The Ngo NA, Vilayphone T, Duong TX, Hoa NL, Pays JF, Buchy P, Goujon C, Bouchaud O, Consigny PH, de Gentile L, D'Ortenzio E, Gautret P, Sorge F, Strady C, Pichard E, Haddar C, Bégaud E, Yuh MY, Law EL, Germani Y, Bouchaud O, Houze S, Chandenier J, Jannin J, Solano P, Quick I, Debre P, Guyon P, Ensaf A, Bourée P, Fabre-Teste B, El Mouden M, Soula G. [X e International Congress of the Société de pathologie exotique, 8-9 November 2017, Haiphong (Vietnam) - Surgery Access in Tropical Areas]. Bull Soc Pathol Exot 2018; 110:353-354. [PMID: 29299881 DOI: 10.1007/s13149-017-0586-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Y Buisson
- Société de pathologie exotique, Institut Pasteur, 25 rue du Docteur-Roux, Paris, 75015, France.
| | - P Guyon
- Ordre de Malte, Paris, France
| | - Y Buisson
- Société de pathologie exotique, Institut Pasteur, 25 rue du Docteur-Roux, Paris, 75015, France
| | - N Osinki
- Hôpital Universitaire Pitié-Salpêtrière et CIMI, Paris, France
| | - C Tamames
- Hôpital Universitaire Pitié-Salpêtrière et CIMI, Paris, France
| | - J Leconte
- Hôpital Universitaire Pitié-Salpêtrière et CIMI, Paris, France
| | - M Jarry
- Hôpital Universitaire Pitié-Salpêtrière et CIMI, Paris, France
| | - J Robert
- Hôpital Universitaire Pitié-Salpêtrière et CIMI, Paris, France
| | | | - O Choua
- Service de Chirurgie Générale, Hôpital Général de Référence Nationale (HGRN), Faculté des Sciences de la Santé Humaine, BP 130, N'Djaména, Chad
| | - M O Ahmat
- Service de Chirurgie Générale, Hôpital Général de Référence Nationale (HGRN), Faculté des Sciences de la Santé Humaine, BP 130, N'Djaména, Chad
| | - K M Moussa
- Service de Chirurgie Générale, Hôpital Général de Référence Nationale (HGRN), Faculté des Sciences de la Santé Humaine, BP 130, N'Djaména, Chad
| | - D Sabe
- Service de Chirurgie Générale, Hôpital Général de Référence Nationale (HGRN), Faculté des Sciences de la Santé Humaine, BP 130, N'Djaména, Chad
| | - A Telniaret
- Service de Chirurgie Générale, Hôpital Général de Référence Nationale (HGRN), Faculté des Sciences de la Santé Humaine, BP 130, N'Djaména, Chad
| | - A M Rabo
- Service de Chirurgie Générale, Hôpital Général de Référence Nationale (HGRN), Faculté des Sciences de la Santé Humaine, BP 130, N'Djaména, Chad
| | - N Kitoko
- Service de Chirurgie Générale, Hôpital Général de Référence Nationale (HGRN), Faculté des Sciences de la Santé Humaine, BP 130, N'Djaména, Chad
| | - B Allatombaye
- Service de Chirurgie Générale, Hôpital Général de Référence Nationale (HGRN), Faculté des Sciences de la Santé Humaine, BP 130, N'Djaména, Chad
| | - Duong Bunn
- Hôpital Preah Kossamak, #15, Rue 55, Chaktomuk, Doun Penh, Phnom Penh, Cambodia
| | | | - Le Duc Huy
- Student of Hue University of Medicine and Pharmacy, Hanoi, Vietnam
| | | | - Le Hong Tram
- Student of Hue University of Medicine and Pharmacy, Hanoi, Vietnam
| | - Tran Van Khoi
- Department of surgery, Hue University, Medicine and Pharmacy, Hanoi, Vietnam
| | - Pham Van Thuc
- Université de Médecine et de Pharmacie de Haiphong, Hanoi, Vietnam
| | - Pham Van Linh
- Département des Ressources Humaines de l'UMPH - Hôpital Universitaire de Haiphong, Hanoi, Vietnam
| | - K Kourouma
- Université des Montagnes, Bangangté, Cameroun
| | - F T Gerald
- Hôpital Régional de Bafoussam, Bafoussam, Cameroun
| | - K Kourouma
- Université des Montagnes, Bangangté, Cameroun
| | - P O Saibou
- Hôpital Régional de Bafoussam, Bafoussam, Cameroun
| | - G C Ngunyi
- Hôpital Régional de Bafoussam, Bafoussam, Cameroun
| | - B Wombe
- Hôpital Régional de Bafoussam, Bafoussam, Cameroun
| | - P Alessandroni
- Association Asie Horizon 2020, 25 bld Herriot, Marseille, 13008, France
| | - R Andrei
- Association Asie Horizon 2020, 25 bld Herriot, Marseille, 13008, France
| | - J Delmont
- Association Asie Horizon 2020, 25 bld Herriot, Marseille, 13008, France
| | - C Gasiglia
- Association Asie Horizon 2020, 25 bld Herriot, Marseille, 13008, France
| | - V V Haï
- Département Maladies Infectieuses et Tropicales, Hôpital Viet Tiep, Haïphong, Vietnam
| | - M Heng
- Bureau de la Santé, Phnom Penh, Cambodia
| | - T Heng
- Cambodian Women for Peace and Development, Phnom Penh, Cambodia
| | - C Khampho
- Hôpital de Savannakhet, Province de Champassak, Laos
| | - D Mekhalfa
- Association Asie Horizon 2020, 25 bld Herriot, Marseille, 13008, France
| | - S Marcaggi
- Association Asie Horizon 2020, 25 bld Herriot, Marseille, 13008, France
| | | | - J-R Plotton
- Association Asie Horizon 2020, 25 bld Herriot, Marseille, 13008, France
| | - N A The Ngo
- Département Maladies Infectieuses et Tropicales, Hôpital Viet Tiep, Haïphong, Vietnam
| | | | | | - Nguyen Lam Hoa
- Oncology Department of Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - J-F Pays
- Société de pathologie exotique, Institut Pasteur, 25 rue du Docteur Roux, 75015, Paris, France
| | - P Buchy
- Université du Nordeste, CENPETROP de Corrientes, Corrientes, Argentine
| | - C Goujon
- GSK Vaccines R&D, 150 beach Road, unit 22-00, 189720, Singapore, Singapore
| | - O Bouchaud
- Centre de vaccinations international, Centre médical de l'Institut Pasteur, 209-211 rue de Vaugirard, 75015, Paris, France
| | - P-H Consigny
- Centre de vaccinations international, Centre médical de l'Institut Pasteur, 209-211 rue de Vaugirard, 75015, Paris, France
| | - L de Gentile
- Centre de vaccinations international, Centre médical de l'Institut Pasteur, 209-211 rue de Vaugirard, 75015, Paris, France
| | - E D'Ortenzio
- Centre de vaccinations international, Centre médical de l'Institut Pasteur, 209-211 rue de Vaugirard, 75015, Paris, France
| | - Ph Gautret
- Centre de vaccinations international, Centre médical de l'Institut Pasteur, 209-211 rue de Vaugirard, 75015, Paris, France
| | - F Sorge
- Centre de vaccinations international, Centre médical de l'Institut Pasteur, 209-211 rue de Vaugirard, 75015, Paris, France
| | - C Strady
- Centre de vaccinations international, Centre médical de l'Institut Pasteur, 209-211 rue de Vaugirard, 75015, Paris, France
| | - E Pichard
- Centre médical de l'Institut Pasteur (CMIP), 209-211 rue de Vaugirard, 75015, Paris, France
| | - C Haddar
- BioSpeedia, Institut Pasteur, 25 rue du Dr Roux, 75015, Paris, France
| | - E Bégaud
- BioSpeedia, Institut Pasteur, 25 rue du Dr Roux, 75015, Paris, France
| | - Mook Yun Yuh
- BioSpeedia, Institut Pasteur, 25 rue du Dr Roux, 75015, Paris, France
| | - Eng Lim Law
- BioSpeedia, Institut Pasteur, 25 rue du Dr Roux, 75015, Paris, France
| | - Y Germani
- BioSpeedia, Institut Pasteur, 25 rue du Dr Roux, 75015, Paris, France
| | - O Bouchaud
- CHU Avicenne-APHP et Université Paris 13, Paris, France
| | - S Houze
- CHU Bichat-APHP et Université Paris 7, Paris, France
| | | | | | | | | | | | | | - P Guyon
- Ordre de Malte, Paris, France
| | - A Ensaf
- Unité des Maladies Infectieuses et Tropicales d'Outre-Mer, Association Humains, 7, Santé et Futur, 75020, Paris, France
| | - P Bourée
- Institut Alfred Fournier 7, 75014, Paris, France
| | - B Fabre-Teste
- Centres de Lutte Anti-Tuberculose du Littoral et de Lens (Pas-de-Calais), 7, Paris, France
| | - M El Mouden
- Permanence d'Accès aux Soins de Santé de l'Hôpital de Calais, Paris, France
| | - G Soula
- Faculté de Médecine de Marseille, Paris, France
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Kondé MK, Diop MK, Curtis MY, Barry A, Kouyaté S, Ghilardi L, Kouyaté S, Diallo AM, Magassouba N, Quick I, Keïta M, Carroll MW, Jansa J, Subissi L. Sex practices and awareness of Ebola virus disease among male survivors and their partners in Guinea. BMJ Glob Health 2017; 2:e000412. [PMID: 29018586 PMCID: PMC5623339 DOI: 10.1136/bmjgh-2017-000412] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 08/16/2017] [Accepted: 08/17/2017] [Indexed: 02/01/2023] Open
Abstract
Introduction Towards the end of the 2013–2016 West African outbreak, sexually-transmitted Ebola virus re-emerged from Ebola virus disease (EVD) survivors in all three hardest hit countries. We explore sex practices and awareness of the risk of Ebola virus transmission among EVD survivors and their partners. Methods In this cross-sectional study, we recruited a convenience sample of study participants aged >15 years who were male EVD survivors, their sexual partners and a comparison group. We administered a questionnaire to all respondents, estimated self-reported sexual practices and risk awareness and conducted in-depth interviews. Results We recruited 234 EVD survivors, 256 sexual partners of survivors and 65 individuals in the comparison group from five prefectures in Guinea. The prevalence of safe sexual behaviour (regular condom use or sexual abstinence >12 months) and regular condom use in EVD survivors was 38% (95% CI 31% to 44%) and 21% (95% CI 16% to 27%), respectively. Among partners, these prevalences were lower (11%, 95% CI 7% to 15% and 9%, 95% CI 5% to 12%, respectively). EVD survivors were more than five times as likely to engage in safe sexual behaviour compared with the comparison group (aOR 5.59, 95% CI 2.36 to 13.2). One-hundred and thirty one EVD survivors (57%) and 94 partners (37%) were aware of the risk of Ebola virus re-emergence associated with having unsafe sex. Partners who reported not being informed by their husband/boyfriend (EVD survivor) were more likely to be unaware of this risk (aOR 20.5, 95% CI 8.92 to 47.4). Conclusions We disclose here a need to improve knowledge of the disease and close the gap between knowledge and practice found in EVD survivors and their partners. Current and future survivors’ follow-up programmes should include partners and be more effective at communicating sex-related risks. Community-level fears and attitudes that enable stigmatisation should be addressed. Safe sex interventions targeting EVD survivors and their partners should be prioritised.
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Affiliation(s)
- Mandy Kader Kondé
- Department of Public Health, Universite Gamal Abdel Nasser de Conakry, Conakry, Guinea.,Fondation Santé et Développement durable, FOSAD-CEFORPAG, Conakry, Guinea
| | - Moustapha Keita Diop
- Laboratoire d'analyse socio-anthropologique de Guinée (LASAG), Université Général Lansana Conté de Sonfonia-Conakry, Conakry, Guinea
| | - Marie Yvonne Curtis
- Laboratoire d'analyse socio-anthropologique de Guinée (LASAG), Université Général Lansana Conté de Sonfonia-Conakry, Conakry, Guinea
| | - Abdoulaye Barry
- Fondation Santé et Développement durable, FOSAD-CEFORPAG, Conakry, Guinea
| | - Saidou Kouyaté
- Fondation Santé et Développement durable, FOSAD-CEFORPAG, Conakry, Guinea
| | - Ludovica Ghilardi
- Department of Disease Control, Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, UK
| | - Sékou Kouyaté
- Laboratoire d'analyse socio-anthropologique de Guinée (LASAG), Université Général Lansana Conté de Sonfonia-Conakry, Conakry, Guinea
| | - Aissatou Malal Diallo
- Laboratoire d'analyse socio-anthropologique de Guinée (LASAG), Université Général Lansana Conté de Sonfonia-Conakry, Conakry, Guinea
| | - N'faly Magassouba
- Laboratoire des Fièvres Hémorragiques en Guinée, Université Gamal Abdel Nasser de Conakry, Conakry, Guinea
| | - Isadora Quick
- Institut thématique multi-organismes I3M (Immunologie, Inflammation,Infectiologie et microbiologie), Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Mory Keïta
- WHO Country office, World Health Organization, Conakry, Guinea
| | - Miles W Carroll
- Microbiology services, Public Health England, London, London, UK.,University of Southampton, South General Hospital, Southampton, UK
| | - Josep Jansa
- Section of Epidemic Intelligence and Response, European Centre for Disease Prevention and Control, Stockholm, Stockholms Län, Sweden
| | - Lorenzo Subissi
- Section of Epidemic Intelligence and Response, European Centre for Disease Prevention and Control, Stockholm, Stockholms Län, Sweden.,Global Outbreak Alert and Response Network, World Health Organization, Geneva, Switzerland
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