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Global Health Programmes Improve Specific Health Outcomes But Can Constrain Health Systems Of Poor Countries

The emergence of global health initiatives (GHIs), eg, The Global Fund and PEPFAR, has resulted in a striking expansion of key health interventions in recent years, from which millions have benefited. There is also evidence, however, that such initiatives can constrain the health systems of poor countries and that many opportunities to improve efficiency, equity, value for money and outcomes in global public health are still being missed. The health systems strengthening agenda needs more investment, and to be infused with the same sense of ambition and speed that has characterised GHIs. This is one of five key recommendations in a new multi-partner report published in a Health Policy paper in this week"s edition of The Lancet.
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Drop In U.S. Births Began Before Recession, Census Data Show

Newly released Census Bureau data show that even before the current economic recession began in September 2008, population growth among children younger than age one began to decline, the AP/Kansas City Star reports. Between July 2007 and July 2008, the number of children younger than age one in the U.S. increased 0.9%, compared with a record 2.7% increase the previous year. Although births tend to drop during economic downturns as more people decide that they cannot afford to support children, experts said it is not clear why the recent drop began months before the current recession emerged. Stephanie Ventura, a demographer for the National Center for Health Statistics, said that it will be impossible to know what factors contributed to the change until demographic breakdowns are available later this year. The AP/Star reports that increases in teenage births had been driving up birth rates in recent years.Historically, birth rates have declined during poor economic times -- including the recessions of 1973, 1982 and 2001 -- and births dropped nearly 26% during the Great Depression. Mark Mather, an associate vice president at the Population Research Bureau, said, "The economy does matter. If prospects look worse for families, they"re going to be very likely to have fewer kids" (Yen/Wagster Pettus, AP/Kansas City Star, 5/19).