Publication
Ensuring health care services for the poor during a financial crisis. The Medicard Program in Mongolia: experiences and lessons learned

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The SDG Fund response

By incorporating health services and health specialists, the SDG Fund programmes tackle the health challenges and opportunities underlying intersectoral interventions. In addition, the SDG Fund, particularly through the work of the World Health Organization, promotes positive changes in national and local health policies.

For example,

• In Guatemala, the SDG Fund programme is addressing the health damages produced by aflatoxin contamination in corn. A risk analysis report is determining the prevalence and damage to health and a pilot is being tested to be expanded to other regions in the country.

• In Paraguay, the SDG Fund is working with the health system as part of a cross-sector approach for indigenous and vulnerable rural households, particularly female headed families, to produce nutritious and diversified food production. Health personnel is being trained on new monitoring systems to track health and nutrition status.

• In Sri Lanka, the joint programme is addressing food insecurity by closely aligning with national policies and using national surveys for more efficient and effective investments in food security and nutrition by highlighting the gaps, opportunities and impact of current initiatives. For example, the Demographic and Health Survey (DHS) includes a detailed assessment of nutrition for children under 5 and a manual on health and nutrition for preschool is being developed to improve nutrition in schools.

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The SDG Fund response

By incorporating health services and health specialists, the SDG Fund programmes tackle the health challenges and opportunities underlying intersectoral interventions. In addition, the SDG Fund, particularly through the work of the World Health Organization, promotes positive changes in national and local health policies.

For example,

• In Guatemala, the SDG Fund programme is addressing the health damages produced by aflatoxin contamination in corn. A risk analysis report is determining the prevalence and damage to health and a pilot is being tested to be expanded to other regions in the country.

• In Paraguay, the SDG Fund is working with the health system as part of a cross-sector approach for indigenous and vulnerable rural households, particularly female headed families, to produce nutritious and diversified food production. Health personnel is being trained on new monitoring systems to track health and nutrition status.

• In Sri Lanka, the joint programme is addressing food insecurity by closely aligning with national policies and using national surveys for more efficient and effective investments in food security and nutrition by highlighting the gaps, opportunities and impact of current initiatives. For example, the Demographic and Health Survey (DHS) includes a detailed assessment of nutrition for children under 5 and a manual on health and nutrition for preschool is being developed to improve nutrition in schools.

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• By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births

• By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births

• By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases

• By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

• Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol

• By 2020, halve the number of global deaths and injuries from road traffic accidents

• By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes

• Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all

• By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination

• Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate

• Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all

• Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States

• Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks

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• By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births

• By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births

• By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases

• By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

• Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol

• By 2020, halve the number of global deaths and injuries from road traffic accidents

• By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes

• Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all

• By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination

• Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate

• Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all

• Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States

• Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks

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The SDG Fund response

The SDG Fund programmes undertake situation analysis to understand what inequalities underpin the challenges in the communities and countries where we work. By doing this, the programmes pay special attention to inequalities suffered by women, girls, indigenous people, older people, youth, and those living in geographical isolated communities. Our initiatives take inequalities into account and put into practice solutions to address them, responding to the 2030 Agenda’s mandate of leaving no one behind.

For example,

• In Tanzania, the SDG Fund is working with the national government to scale-up one of its existing national programmes to reach all the extreme poor living below the food poverty line. In particular, it’s targeting women, children, youth, elderly, people living with disabilities and people living with HIV and AIDS. The programme employs conditional cash transfers, promoting employment through public works programmes, family planning awareness and primary and secondary school education.

• In Bangladesh, the SDG Fund is working with ultra-poor women, particularly with those who are widowed, divorced or abandoned.  The programme is supporting the most vulnerable households to move out of poverty through public works jobs, education and financial literacy.

• In Paraguay, the SDG Fund is supporting the government’s efforts to find integrated solutions to undernutrition and to address other health problems faced by indigenous and vulnerable rural households, particularly female-headed ones, to produce nutritious and diversified food production.

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The SDG Fund response

The SDG Fund programmes undertake situation analysis to understand what inequalities underpin the challenges in the communities and countries where we work. By doing this, the programmes pay special attention to inequalities suffered by women, girls, indigenous people, older people, youth, and those living in geographical isolated communities. Our initiatives take inequalities into account and put into practice solutions to address them, responding to the 2030 Agenda’s mandate of leaving no one behind.

For example,

• In Tanzania, the SDG Fund is working with the national government to scale-up one of its existing national programmes to reach all the extreme poor living below the food poverty line. In particular, it’s targeting women, children, youth, elderly, people living with disabilities and people living with HIV and AIDS. The programme employs conditional cash transfers, promoting employment through public works programmes, family planning awareness and primary and secondary school education.

• In Bangladesh, the SDG Fund is working with ultra-poor women, particularly with those who are widowed, divorced or abandoned.  The programme is supporting the most vulnerable households to move out of poverty through public works jobs, education and financial literacy.

• In Paraguay, the SDG Fund is supporting the government’s efforts to find integrated solutions to undernutrition and to address other health problems faced by indigenous and vulnerable rural households, particularly female-headed ones, to produce nutritious and diversified food production.

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• By 2030, progressively achieve and sustain income growth of the bottom 40 per cent of the population at a rate higher than the national average

• By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status

• Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard

• Adopt policies, especially fiscal, wage and social protection policies, and progressively achieve greater equality

• Improve the regulation and monitoring of global financial markets and institutions and strengthen the implementation of such regulations

• Ensure enhanced representation and voice for developing countries in decision-making in global international economic and financial institutions in order to deliver more effective, credible, accountable and legitimate institutions

• Facilitate orderly, safe, regular and responsible migration and mobility of people, including through the implementation of planned and well-managed migration policies

• Implement the principle of special and differential treatment for developing countries, in particular least developed countries, in accordance with World Trade Organization agreements

• Encourage official development assistance and financial flows, including foreign direct investment, to States where the need is greatest, in particular least developed countries, African countries, small island developing States and landlocked developing countries, in accordance with their national plans and programmes

• By 2030, reduce to less than 3 per cent the transaction costs of migrant remittances and eliminate remittance corridors with costs higher than 5 per cent

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• By 2030, progressively achieve and sustain income growth of the bottom 40 per cent of the population at a rate higher than the national average

• By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status

• Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard

• Adopt policies, especially fiscal, wage and social protection policies, and progressively achieve greater equality

• Improve the regulation and monitoring of global financial markets and institutions and strengthen the implementation of such regulations

• Ensure enhanced representation and voice for developing countries in decision-making in global international economic and financial institutions in order to deliver more effective, credible, accountable and legitimate institutions

• Facilitate orderly, safe, regular and responsible migration and mobility of people, including through the implementation of planned and well-managed migration policies

• Implement the principle of special and differential treatment for developing countries, in particular least developed countries, in accordance with World Trade Organization agreements

• Encourage official development assistance and financial flows, including foreign direct investment, to States where the need is greatest, in particular least developed countries, African countries, small island developing States and landlocked developing countries, in accordance with their national plans and programmes

• By 2030, reduce to less than 3 per cent the transaction costs of migrant remittances and eliminate remittance corridors with costs higher than 5 per cent

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Poverty struck and access to basic services and medical care plummeted, affecting the health of women and children. The Medicard program was the Mongolian health sector’s first to apply the Proxy Mean Test to target eligible households. It contributed to ensuring government health and social program inclusiveness, and highlighted the critical role of political commitment in ensuring the sustainability of such programs. This paper provides information on the program design and implementation by comparing it with international best practices. [format] => [safe_value] => The 2007–2008 global financial crisis severely affected the Mongolian economy. Poverty struck and access to basic services and medical care plummeted, affecting the health of women and children. The Medicard program was the Mongolian health sector’s first to apply the Proxy Mean Test to target eligible households. It contributed to ensuring government health and social program inclusiveness, and highlighted the critical role of political commitment in ensuring the sustainability of such programs. This paper provides information on the program design and implementation by comparing it with international best practices. ) ) ) [field_year] => Array ( [und] => Array ( [0] => Array ( [value] => 2016-01-01 00:00:00 [timezone] => America/New_York [timezone_db] => America/New_York [date_type] => datetime ) ) ) [field_publication_keywords] => Array ( ) [field_publisher] => Array ( [und] => Array ( [0] => Array ( [value] => ADB [format] => [safe_value] => ADB ) ) ) [field_region] => Array ( [und] => Array ( [0] => Array ( [target_id] => 260 [entity] => stdClass Object ( [vid] => 1020 [uid] => 1 [title] => Asia [log] => [status] => 1 [comment] => 1 [promote] => 0 [sticky] => 0 [nid] => 260 [type] => region [language] => en [created] => 1450896508 [changed] => 1450896508 [tnid] => 260 [translate] => 0 [revision_timestamp] => 1450896508 [revision_uid] => 1 [rdf_mapping] => Array ( [rdftype] => Array ( [0] => sioc:Item [1] => foaf:Document ) [title] => Array ( [predicates] => Array ( [0] => dc:title ) ) [created] => Array ( [predicates] => Array ( [0] => dc:date [1] => dc:created ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [changed] => Array ( [predicates] => Array ( [0] => dc:modified ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [body] => Array ( [predicates] => Array ( [0] => content:encoded ) ) [uid] => Array ( [predicates] => Array ( [0] => sioc:has_creator ) [type] => rel ) [name] => Array ( [predicates] => Array ( [0] => foaf:name ) ) [comment_count] => Array ( [predicates] => Array ( [0] => sioc:num_replies ) [datatype] => xsd:integer ) [last_activity] => Array ( [predicates] => Array ( [0] => sioc:last_activity_date ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) ) [name] => sysadmin [picture] => 0 [data] => a:2:{s:7:"contact";i:0;s:7:"overlay";i:1;} ) [access] => 1 ) ) ) [field_thumb] => Array ( [und] => Array ( [0] => Array ( [fid] => 2102 [uid] => 1 [filename] => eawp-08-1.jpg [uri] => public://eawp-08-1.jpg [filemime] => image/jpeg [filesize] => 66016 [status] => 1 [timestamp] => 1488958245 [type] => image [field_file_image_alt_text] => Array ( ) [field_file_image_title_text] => Array ( ) [rdf_mapping] => Array ( ) [metadata] => Array ( [height] => 792 [width] => 612 ) [alt] => [title] => [height] => 792 [width] => 612 ) ) ) [field_featured] => Array ( ) [field_file_fr] => Array ( ) [field_file_ar] => Array ( ) [field_file_pt] => Array ( ) [field_file_es] => Array ( ) [field_external_link] => Array ( [und] => Array ( [0] => Array ( [value] => https://www.adb.org/sites/default/files/publication/216491/eawp-08.pdf [format] => [safe_value] => https://www.adb.org/sites/default/files/publication/216491/eawp-08.pdf ) ) ) [field_external_link_text] => Array ( [und] => Array ( [0] => Array ( [value] => External Link [format] => [safe_value] => External Link ) ) ) [rdf_mapping] => Array ( [rdftype] => Array ( [0] => sioc:Item [1] => foaf:Document ) [title] => Array ( [predicates] => Array ( [0] => dc:title ) ) [created] => Array ( [predicates] => Array ( [0] => dc:date [1] => dc:created ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [changed] => Array ( [predicates] => Array ( [0] => dc:modified ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [body] => Array ( [predicates] => Array ( [0] => content:encoded ) ) [uid] => Array ( [predicates] => Array ( [0] => sioc:has_creator ) [type] => rel ) [name] => Array ( [predicates] => Array ( [0] => foaf:name ) ) [comment_count] => Array ( [predicates] => Array ( [0] => sioc:num_replies ) [datatype] => xsd:integer ) [last_activity] => Array ( [predicates] => Array ( [0] => sioc:last_activity_date ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) ) [name] => Library Manager 1 [picture] => 0 [data] => a:2:{s:7:"contact";i:0;s:7:"overlay";i:1;} [entity_view_prepared] => 1 ) [#items] => Array ( [0] => Array ( [value] => https://www.adb.org/sites/default/files/publication/216491/eawp-08.pdf [format] => [safe_value] => https://www.adb.org/sites/default/files/publication/216491/eawp-08.pdf ) ) [#formatter] => text_plain [0] => Array ( [#markup] => https://www.adb.org/sites/default/files/publication/216491/eawp-08.pdf ) [#description] => Please enter the full URL, e.g. http://www.example.com [#printed] => 1 )