Two new studies, in Health Affairs July 2013 issue, describe health success stories outside the US.
One, by Sema Sgaier of the Bill & Melinda Gates Foundation, and colleagues, is titled “How The Avahan HIV Prevention Program Transitioned From The Gates Foundation To The Government Of India.” It explains how the Gates Foundation worked with the Government of India to ensure a smooth transition of Avahan – an HIV prevention program funded and initiated by the Gates Foundation – to be run and managed by that government. The transition strategy, implemented in phases between 2009 and 2013, was backed by planning that began in 2005 and received $100 million in funding. This paper calls this example a case study for the transfer of donor-funded programs in middle-income countries such as India, Brazil, China, and South Africa, where government absorption of donor-funded programs is fiscally feasible and increasing country ownership is seen as a solution to diminishing development aid and time-limited donor commitments that challenge long-term sustainability.
The second, by Amie Shei at Analysis Group, a strategy consulting firm in Boston, is titled “Brazil’s Conditional Cash Transfer Program Associated With Declines In Infant Mortality Rates.” The paper describes Brazil’s Bolsa Família conditional cash transfer program, an example of recent actions by the Brazilian government to reduce poverty and inequality and increase access to health care among its poorer residents. The program provides monthly cash transfers to parents, usually the mothers, to finance health care. Participants are required to comply with health guidelines and education guidelines, such as school enrollment, abiding by a vaccination schedule, and regular medical check-ups. The program has expanded rapidly: when it began in 2003, 3.6 million families were covered; by 2008, that number had increased to 11.4 million. In the study, Shei found that the average treatment effect of the program was a 9.3 percent decline in infant mortality rates and a 24.3 percent decline in post neonatal mortality rates.