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Towards sustainability of the physical rehabilitation sector through sector development within broader health systems

URSEAU, Isabelle
BOGGS, Dorothy
November 2013

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This brief is a summary of Handicap International’s Sustainability of physical rehabilitation initiatives. To date these include a four year study, a participatory methodology, an international seminar and ongoing trainings, workshops and monitoring results, all of which exhibit our knowledge management cycle

PG Brief No 8

The sustainability analysis process : the case of physical rehabilitation

BLANCHET, Karl
BOGGS, Dorothy
December 2012

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"This guide describes the Sustainability Analysis Process (SAP), a coordinated planning approach that aims to facilitate the development of a common vision of sustainability among various actors in a system. Specifically, it is a participatory process which outlines how to achieve consensus on a common vision, and how to define sustainability indicators that can be used to monitor progress towards this vision within the context of the national rehabilitation system. Ultimately, the SAP outlined in this guide is a practical tool that can help all actors in a system to understand the various components of sustainability and analyse the concept of sustainability in relation to their own system"

Current issues in sector-wide approaches for health development : Uganda case study

BROWN, Adrienne
2000

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This brief document reports on the broad achievements and constraints faced in the health sector in Uganda. Poverty-reduction funds are being channelled into primary care, and improved management of public funds is helping the situation. However, capacity beyond the Ministry of Health is limited, and decentralization, with unclear policy links in the regions, is a challenge. There is some evidence of success in using funding strategies to reorient services to primary care and prevention

Current issues in sector-wide approaches for health development : Tanzania case study

BROWN, Adrienne
2000

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[Publisher's abstract:] A case study of experiences with an advanced sector-wide approach for health development in Tanzania, where a significant number of activities in the health sector are supported by pooled donor funds disbursed through the government system. These funds are integrated into the government budget cycle, with donors increasingly agreeing to make commitments and disbursements in line with government budgetary requirements. The case study opens with an overview of the country's economic, political, and health situation, concentrating on the implications of recent public sector and government reforms. The next section explains the financing, monitoring, and management of the country's sector-wide approach to donor coordination and budgeting. Eight strategies, adopted to improve the availability and quality of essential health services, are also briefly discussed to illustrate how adoption of a sector-wide approach can help tackle inequities in the health system. Having examined key features of the country's advanced sector-wide approach, the case study considers lessons learned and their applicability to similar efforts in other countries. Questions discussed include the importance of government leadership and ownership, the role of donor involvement in joint disbursement procedures, and the extent to which signed agreements can make donor funds more predictable. The study concludes that, despite high aid dependency, government ownership of the programme is growing, and national commitment to sector programmes and public expenditure reform has created a positive environment for expansion. The high costs of transactions and the additional administrative burden imposed on governments remain major problems

Sector-wide approaches for health develpment : a review of experience

FOSTER, M
BROWN, A
CONWAY, T
2000

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[Publisher's abstract:] Summarizes lessons learned in five countries which are attempting to implement a sector-wide approach to health development. The sector-wide approach is a comparatively recent mechanism for coordinating the roles of governments and donors. A significant characteristic of this approach is the use of all significant funding to support a single sector policy and expenditure programme, under government leadership, with eventual reliance on the government to disburse and account for all funds. The approach also involves a transition of donor contributions away from project-funded vertical programmes and towards a single budget administered by the government. Case studies of the successes and failures of this approach were conducted in Cambodia, Mozambique, Tanzania, Uganda, and Viet Nam. Although these countries represent a range of different stages of implementing the approach, the review reached a number of conclusions about shared problems and impediments to progress. These include weaknesses in government monitoring procedures and a corresponding reluctance of donors to relinquish control, increased demands on staff within ministries of health, and a management complexity that can overwhelm government capacity. On the positive side, the review found evidence of greater agreement on a more restricted range of priorities, better integration of individual programmes within the budget planning process, better links between policy and implementation, and improved understanding of barriers to service utilization, including the role of corruption and incentive problems. On the basis of this assessment, the review issues six key recommendations for improved sector-wide management of projects and resources

A guide to sector-wide approaches for health development : concepts, issues and working arrangements

CASSELS, Andrew
1997

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Introduces and explains the concept of sector-wide approaches, which involves a partnership between governments and all donors working in the health sector, whereby goals are jointly set, coherent sector-wide strategies are mutually agreed, funding is allocated in line with goals and strategies, and actions and responsibilities are collective, though ownership belongs to the government. The approach also calls for the concentration of funding on interventions of proven effectiveness, and the use of national systems for financial management, monitoring, and the procurement of goods and services. Although experience with the approach is limited, the author cites convincing evidence of its potential to overcome many long-standing problems in the provision of development aid. The strategy also responds to growing recognition that, when attempting to achieve sustained improvements in health, sector-wide approaches offer a better prospect of success than the piecemeal pursuit of separately financed projects. With this potential in mind, the author sets out a framework for understanding the strengths and weaknesses of the approach, the way it works in practice, the problems that are likely to arise, and procedures and mechanisms for overcoming these problems. Topics discussed range from the specific circumstances where sector-wide approaches are most appropriate, through ways of ensuring that investments reduce poverty and inequities, to the types of formal agreements needed to minimize misunderstandings. [Publisher's abstract, amended]

Sustaining ability

HANDICAP INTERNATIONAL (HI)
International Centre for Evidence on Disability (ICED)

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This website enables interested individuals to learn more about sustainability and the Sustainability Analysis Process (SAP) through new and up-to-date technical information and practical case studies. The SAP is a coordinated participatory planning approach that facilitates the development of a common vision of sustainability among various actors in a system by outlining how to achieve a consensus on a common vision and how to define sustainability indicators using the six components of the Sustainability Framework. Resource links are provided to the SAP methodological guide, rehabilitation and health system case study reports, workshop facilitator guides, videos and related organisations

Indicators for CBR programmes

DEEPAK, Sunil

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This paper explores how to improve the use of indicators to more effectively compare CBR programmes at national and international levels. It is noted that there is a wide variation in the indicators used by CBR programmes in different countries and even amongst different projects in the same country which makes it difficult to compare the effectiveness of programmes. The paper presents the indicator results of participants' discussions when divided into two groups to analyse the possible indicators for CBR programmes - one group focused upon the major participants of CBR programmes and the second group focused upon different sectors involved in CBR programmes.  It recommends that the indicators identified need to be field tested to gauge their effectiveness. This paper would be useful for anyone involved in the preparation, delivery or evaluation of CBR programmes

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