Service Delivery
USAID’s CNHA Health Facility Readiness and Functionality Assessment, 2024
The Community Nutrition and Health Activity (CNHA), funded by the United States Agency for International Development (USAID), is dedicated to enhancing the nutritional status of women and children within vulnerable 1000-day households in Bangladesh—those with pregnant and lactating women and/or children under two years. This assessment, conducted between March and June 2024, evaluated the readiness and functionality of 1,336 community clinics (CCs) and 354 Union Health and Family Welfare Centers (UH&FWCs) across 14 districts. It aimed to identify strengths and weaknesses in key operational areas, including governance and management, health workforce presence, service delivery, logistics, and information systems. The findings revealed a significant presence of community groups in CCs but highlighted operational gaps in regular meetings and management practices. While the availability of maternal and child health services was generally high, discrepancies existed in the provision of family planning methods and comprehensive nutritional services. The assessment serves as a foundational tool for CNHA to target interventions, enhance health systems, and improve overall community health outcomes by integrating these findings into local government improvement plans.
Total Page No: 62 Read More...
Total Page No: 62 Read More...
Who pays to deliver vaccines? An Analysis of World Bank Funding for COVID-19 Vaccination and Recovery
The World Bank is one key source of funding in the global push to vaccinate 70% of the world’s population against COVID-19. Many actors point to this as the funding that will cover any additional delivery needs for COVID-19 vaccines that national governments cannot meet. With $5.8 billion in funding already approved out of a $20 billion commitment, the World Bank funding is an important part of the picture, but the World Bank alone cannot cover the full gap in vaccine delivery needs.
Reviewing 60 funding agreements from the World Bank on COVID-19 vaccination and recovery shows the following insights.
• There is still a gap in delivery funding. The World Bank is currently funding $1.2 billion in vaccine delivery—10% of the total funding allocated for COVID-19 recovery. If that trend applies to the rest of the $20 billion commitment, World Bank funding will cover a between $2 and $4 billion—well below the $9 billion that ACT-A estimates as the lowest possible investment to vaccinate 70% of the world’s population. In contrast, $3.1 billion is going to purchase vaccines.
• Health workers remain underfunded. Only 15 of 60 agreements, just 25% detail provisions to pay health workers. Of those, 7 explicitly fund surge capacity, 3 provide for ongoing salaries, and 4 allow for hazard pay to health workers.
• Countries are taking on debt to rollout COVID-19 vaccinations. 86% of the funding in this analysis is in the form of loans. That gives countries debt that may weaken future pandemic preparedness rather than reinforcing health systems.
• All funders should adopt the World Bank’s commitments to investments in gender equality. 90% of the agreements in this analysis refer to gender inequality and many make corresponding investments—like requiring that 60% of vaccine leadership positions are women—to overcome these barriers. Earmarking exact funds going to advance gender equality would provide further transparency. Nevertheless, this consistent and concrete commitment is commendable, and all actors should strive to replicate it.
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Reviewing 60 funding agreements from the World Bank on COVID-19 vaccination and recovery shows the following insights.
• There is still a gap in delivery funding. The World Bank is currently funding $1.2 billion in vaccine delivery—10% of the total funding allocated for COVID-19 recovery. If that trend applies to the rest of the $20 billion commitment, World Bank funding will cover a between $2 and $4 billion—well below the $9 billion that ACT-A estimates as the lowest possible investment to vaccinate 70% of the world’s population. In contrast, $3.1 billion is going to purchase vaccines.
• Health workers remain underfunded. Only 15 of 60 agreements, just 25% detail provisions to pay health workers. Of those, 7 explicitly fund surge capacity, 3 provide for ongoing salaries, and 4 allow for hazard pay to health workers.
• Countries are taking on debt to rollout COVID-19 vaccinations. 86% of the funding in this analysis is in the form of loans. That gives countries debt that may weaken future pandemic preparedness rather than reinforcing health systems.
• All funders should adopt the World Bank’s commitments to investments in gender equality. 90% of the agreements in this analysis refer to gender inequality and many make corresponding investments—like requiring that 60% of vaccine leadership positions are women—to overcome these barriers. Earmarking exact funds going to advance gender equality would provide further transparency. Nevertheless, this consistent and concrete commitment is commendable, and all actors should strive to replicate it.
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Midterm Performance Evaluation of the Bangladesh NGO Health Service Delivery Project (NHSDP)
This 159 page evaluation assesses the status, relevance and sustainability of the NHSDP project and ... Read More...