世界银行-基里巴斯共和国初级卫生保健系统：初级卫生保健绩效倡议评估（英）-2023..docx

P N-o号<alnsoosQ-qndpzo 号 V alnsoosQ-qndTHEPRIMARYHEALTHCARESYSTEMOftherepublicOfkiribatiAPRIMARYHEALTHCAREPERFORMANCEINITIATIVEASSESSMENTVALERIACRUZ-VILLALBAMARWARAMADANCAMERONSCOTTFEILAWADIALLOLATIFATOKARAMANUELAVILLARURIBEworldBankgroup-jHealth,NutritionAPopulationHITHEPRIMARYHEALTHCARESYSTEMOftherepublicOfkiribatiAprimaryhealthcareperformanceINITIATIVEASSESSMENTVALERIACRUZ-VILLALBAMARWARAMADANCAMERONSCOTTFEILAWADIALLOLATIFATOKARAMANUELAVILLARURIBEReportpreparedbytheWorldBankinconsultationwiththeMinistryofHealthandMedicalServices,GovernmentofKiribatiworld BankgroupHealth, Nutrition 1 Populationophcpi©2023TheWorldBankGroup1818HStreetNW,WashingtonDC20433Telephone:202-473-1000;Internet:www.worldbank.organdwww.ifc.org.SOMERIGHTSRESERVED.ThisworkisaproductofthestaffofTheWorldBank(theWorldBankGroup)withexternalcontributions.Thefindings,interpretations,andconclusionsexpressedinthisworkdonotnecessarilyreflecttheviewsofTheWorldBank,sBoardofExecutiveDirectors,orthegovernmentstheyrepresent.TheWorldBankdoesnotguaranteetheaccuracyoftheinformationincludedinthiswork.Theboundaries,colors,denominations,andotherinformationshownonanymapinthisworkdonotimplyanyjudgmentonthepartofTheWorldBankconcerningthelegalstatusofanyterritoryortheendorsementoracceptanceofsuchboundaries.RIGHTSANDPERMISSIONS.Thematerialinthisworkissubjecttocopyright.BecausetheWorldBankencouragesdisseminationofitsknowledge,thisworkmaybereproduced,inwholeorinpart,fornoncommercialpurposesaslongasfullattributiontotheworkisgiven.ATTRIBUTION.Pleasecitetheworkasfollows:,zWorldBankGroup.2023.ThePrimaryHealthCareSystemoftheRepublicofKiribati:APrimaryHealthCarePerformanceInitiativeAssessment,(c)WorldBankGroup."Allqueriesonrightsandlicenses,includingsubsidiaryrights,shouldbeaddressedtoWorldBankPublications,TheWorldBankGroup,1818HStreetNW,Washington,DC20433zUSA;fax:;email:PUbrightSworldbank.org.DISCLAIMER.ThePHCPIisapartnershipdedicatedtotransformingtheglobalstateofprimaryhealthcare,beginningwithbettermeasurement.Whilethecontentinthisreportrepresentsthepositionofthepartnershipasawhole,itdoesnotnecessarilyreflecttheofficialpolicyorpositionofanyspecificpartnerorganization.Acknowledgments6Abbreviations7ExecutiveSummary9Introduction15Countrycontext16Economiccontext16Genderlandscape17AboutPrimaryHealthCarePerformanceInitiatives18Methodology21KeyfindingsfromtheVSP24Results25Performance26Access26Coverage28Quality31Equity34Capacity37Governance37Inputs42Populationhealthmanagement47Financing50Recommendations51References62Annexes65Annex 1 rimaryHealthCarePerformanceInitiativeFramework66Performancedomain671.ISTOFFIGURESTable1,CoverageofservicesforRMNCH,infectiousdiseases,andNCDsusingdatafromthemostrecenthouseholdsurveysandmonitoringreportsinKiribati28Box1.OverviewofNCDpoliciesandstrategies37Box2.OverviewofNCDgovernanceandimplementation39Box3:Deep-diveintogovernanceandgender40Box4.OverviewofNCD-relatedinformationsystemsandfeedbackmechanisms44Box5:Deep-diveintoinputsandgender46Box6:Deep-diveintopopulationhealthandfacilitymanagementandgender49ACKNOWLEDGMENTSThisreportpresentsthekeyfindingsofthePrimaryHealthCarePerformanceInitiativeassessmentintheRepublicofKiribati,whichwascompletedbyaWorldBankteamledbyManuelaVillar-UribeandWayneJeremyIravaincollaborationwiththeMinistryofHealthandHumanServicesoftheRepublicoftheMarshallIslands.QualitativedatacollectionandanalysiswasledbyValeriaCruz-VillalbawithsupportfromIobiBatio.QuantitativedataanalysisandcurationwereledbyMarwaRamadan.CameronFeiLAwaDiallozandLatifatOkaraprovidedanalyticinputandwritingsupporttothisreport.DiegoHernanVaporeprovideddesignsupport.LucyHartshornzCaitlinNoonan,andBaldeepDhaliwalalsoprovidedcriticalinputatdifferentphasesoftheassessment.Theteamisgratefulfortheoutstandingleadership,support,andguidanceprovidedbytheMinistryofHealthandMedicalServices,Kiribati-Dr.TekeuaUriam(DirectorHospitalServices),Ms.EretiTimeon(DirectorPublicHealth),Ms.HelenMurdoch(DirectorNursingServices),Dr.TanebuTong(DeputyDirectorPublicHealth),Dr.AlfredTonganibeia(DeputyDirectorHospitalServices),andMs.ToataTitaake(DeputyDirectorNursingServices).Theyprovidedvaluableinputandmobilizedsupportfortheassessment/ssuccess.Theteamalsothanksthekeyinformantsinterviewedfortheirtimeandcontributions,withoutwhichthisassessmentwouldbeincomplete.ABBREVIATIONSANCAntenatalcareCEDAWConventionontheEliminationofallFormsofDiscriminationAgainstWomenCSOCivilsocietyorganizationDPT3Diphtheria-pertussis-tetanus,thirddoseEHRElectronichealthrecordGBVGender-basedviolenceGDPGrossdomesticproductHIESHouseholdincomeandexpendituresurveyHIVHumanImmunodeficiencyVirusHMISHealthManagementInformationSystemMHMSMinistryofHealthandMedicalServicesMICSMultipleIndicatorsClusterSurveyMWYSSAMinistryofWomen,Youth,Sport,andSocial