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The central principle of HSDI involves backing reforms with resources, thus incentivising the process of addressing some of the more difficult health challenges. The programme is expected to contribute directly to the achievement of some key outcomes: reduction by about a third in the Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR) rates; increase in the proportion of institutional deliveries, especially in the six poor performing districts; significant increase in the coverage of child immunisation; and, reduction in the share of burden of disease from communicable / maternal / neonatal factors.
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The programme aims to direct additional financial resources to three priority and under-funded areas: primary sub-sector, rural areas, and non-wage recurrent expenditures like drugs. The proposed support is also expected to address some difficult institutional reforms – e.g. removing vacancies in critical areas and reducing the level of absenteeism, especially of front-line staff. These and other measures are expected to improve patient satisfaction and the quality of care provided by the public sector. Other intended benefits of the programme include better capacity to regulate private sector, and involving the private sector (much of it not-for-profit) in innovative means of delivering essential preventive and basic curative services. There will also be provision for running some cutting-edge pilots, such as on community health insurance, and public-private partnerships (GoWB has already begun working more closely with the private and NGO sector in some areas).
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The programme will support eight key elements of reform mapped out in the strategy: strategic and policy framework, organisation and management systems, health financing, access and demand for services, involving the private sector, assets and suply management, procurement and financial management systems, and health coverage priorities. Milestones for each area have been agreed with the DoHFW. |
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