健康体系中暂停和减少卫生官方发展援助的影响

The impact of suspensions and reductions in healthofficial development assistance on health systems Rapid WHO country office stock take Summary of results from 108 WHO country offices, 7 March–2 April 2025(10 April 2025 version) The impact of suspensions and reductions in health official development assistance (ODA)on health systems: 7March–2 April 2025 OBJECTIVE |Rapidly gather insights from WHO country offices on the impact of health ODA suspensions & reductions on health systems Scope Caveats (Limitations) -Key informant responses–not verified byquantitative assessment-Notrepresentative of governmentreporting (WHOperspective)-Variable completion rates by question(denominatorvaries)-A snapshotat oneperiod in time-Not reflective of thedynamic situation 1.Snapshot ofdisruptionsacrosshealthsystem areasand programmesthrough108 WHO country offices,primarilyinlowandlower-middleincomecountries,facingorexpectingsuspension orreductionsinhealthODAacrossall six WHOregions 2.Mitigationmeasuresimplemented 3.Critical bottlenecks & countrysupport needs Key findings: •Current extent of suspended/reduced health officialdevelopment assistance (ODA)•Impact on health systems & mitigation efforts More than half (56%) of responding WHO country offices (n=57)* reported moderate or severe suspensionof health ODA Effects of current ODA reductions & suspensions onhealth system areas -80% (85 of 106)ofWHO countryofficesreported at least one health system area has been disrupted-Health system areas mostseverelyaffected include: humanitarian aid,health emergency preparedness & response,public health surveillance & service provision Health financing effects & mitigation measures Extent of service disruptions -71% (75 of 106) of WHOcountry officesreported disruptions to at least one service area-Service areas mostseverelyaffected include: malaria, NTDs, vaccination(clinic-based & outreach),TB,andsexually transmitted infections, family planning, outbreak detection & reporting-Disruptions for potentially life-saving emergency, critical & operative care are particularly concerning maternal and child health, Service provision effects & mitigation measures Effects on health product availability Including medicines, medical devices including diagnostics, vaccines, assistive products and other health products Over 1/3 of WHO country offices reported shortagesof medicines and health productsfor key diseases and conditions -Health product availabilitymostseverelyaffected for: vaccines (clinic-based & outreach), outbreak detection & reporting,noncommunicable diseases, sexually transmitted infections, and neglected tropical diseases Health products availability mitigation measures Including medicines, medical devices including diagnostics, vaccines, assistive products and other health products Most common measuresinclude: Seeking alternative donorsto procure health productsIncreasing domesticprocurement of healthproductsStrengthened public-private partnerships Effects on health & careworkers Over half (63%) of WHO country offices reported job-relatedimpacts on health & care workers in countries, including: -47% of WHO country offices (50/106) reported that at leastone health occupation has been affected by the currentreductions in health ODA. -job losses (53%)-temporary leave (28%)-salary suspension (28%)-salary reduction (12%) -Community health workers (CHWs), medical doctors andnursing and midwifery personnel are among the occupationsmost frequently affected (>50% of responding WHO countryoffices) -The second most commonly reported effect was disruptionin training* (18%) *Examples of other affected occupations: Health promotion & prevention specialists; Social workers &psychosocial staff; Laboratory staff & other ancillary health workers; Public health professionals; NGOworkers/consultants; Other admin, financial, programme management, transport & support staff *35 countries reported both job-related impacts as well as disruptions to training opportunities.In these instances, the response was counted as job-related impact alone as it is considered themore severe effect. Most common measures include: Optimization of service (tasksharing) or redistribution acrosslevels of care (40%)Layoffs / furloughs/ asking healthand care workers to work asvolunteers (33%)Reduce absorption of newgraduates/freeze recruitment(18%)Salaries fully/partially paid bygovernments (12%) Most WHO country offices expect further impact on future health and care worker recruitment in countries (69% of 83) Over 40% of WHO countryofficesreported country disruptions to: collaborative surveillance & emergencymanagement information systems, health management information systems, other disease-specific reporting systems,household/population surveys & lab information systems Health information mitigation measures % of WHO country offices reporting mitigation measures for data sources & systems (n=69) Over 40% of WHOcountry offices r