The Exemplar Newsletter: May/June 2024
Exemplars in Global Health
We provide evidence-based insights from positive outliers to help decision-makers achieve large-scale success.
The following is an excerpt from the monthly newsletter from Exemplars in Global Health, a global coalition of partners on a mission to identify positive health outliers, analyze what makes countries successful, and disseminate core lessons so they can be adapted in comparable settings.
Read on to hear from Niranjan Bose, Health and Life Sciences Managing Director at Gates Ventures. You can also subscribe to The Exemplar to hear more from the program on a monthly basis.
Research in primary health care
Many of us know that improving maternal, newborn, and child health starts with strong primary health care (PHC) systems – systems that ensure access to high-quality and equitable care for all. But now, more than ever, there is a need to understand how countries can stretch their limited resources to achieve more health for each dollar spent. New research on primary health care from Exemplars in Global Health tackles this question, reinforcing that efficient PHC systems can move us closer to achieving the health goals we are driving towards.
This is what we’ve seen in Zambia, and one of the reasons why the country is an Exemplar in primary health care. By implementing a series of reforms to its health system over decades, Zambia was able to improve its primary health care system’s performance, realizing significant gains in coverage across critical health services and outcomes despite only modest increases in health spending per capita. For example, Zambia increased skilled birth attendance from 44% to 80% between 2000 and 2019, and saw maternal mortality rates decrease by 39% during roughly the same time, while only increasing total health expenditure by 15%.
Through efficient spending and strategic planning, financing Zambia’s health care system became more predictable, enabling the regular delivery of services all the way down to local levels. Second, improving the geographic distribution of health workers, and improving their overall working conditions optimized the nation’s health workforce, resulting in nearly double its combined density of doctors, nurses, and midwives in just 12 years. Finally, by bringing services closer to people and communities, Zambia improved the accessibility and utilization of health services, thereby decreasing barriers to care.
Zambia’s success was hard-won. Over time, the country has been able to improve its primary health system to efficiently and equitably ensure access to care nationwide. While not simple, these solutions may present a possibility for other countries as well.
I invite you to learn more about how Zambia strengthened its PHC system, and to stay tuned for new publications on how Peru, Bangladesh, Ghana, and Rwanda did the same by spending well, and spending enough, in primary health care.
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Research and upcoming events
A study from Exemplars in Global Health found the highest performing countries share many key drivers that contribute to their progress, including efficient data systems and intentional women’s empowerment.
Recently published research from Exemplars in Global Health identifies successful strategies and interventions that have contributed to reduced neonatal and maternal mortality rates worldwide.
Researchers from Exemplars in Global Health will host a panel discussion about the research being conducted around advance warning and response.