Personnel Management 03-09-2013 Inesa Voronchuka University of Latvia, Latvia.
Table of Contents - vm.gov.lv · Latvia in 2015 life expectancy for men was 68.8 years, while that...
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Transcript of Table of Contents - vm.gov.lv · Latvia in 2015 life expectancy for men was 68.8 years, while that...
Table of Contents
INTRODUCTION .................................................................................................................... 1
TERMS OF COLLABORATION ........................................................................................... 3
PART 1. SETTING PRIORITIES FOR COLLABORATION FOR 2018–2019 .................. 4
1.1 Health situation analysis ....................................................................................................................4
1.2 Priorities for collaboration ................................................................................................................5
1.2.1 Health 2020 and the 2030 Agenda in Latvia ............................................................................................. 5
1.2.2 Linkage of BCA with national and international strategic frameworks for Latvia .................................... 5
1.2.3 Programmatic priorities for collaboration .................................................................................................. 5
PART 2. BUDGET AND COMMITMENTS FOR 2018–2019 ............................................... 7
2.1 Budget and financing .........................................................................................................................7
2.2 Commitments ......................................................................................................................................7
2.2.1 Commitments of the WHO Secretariat ...................................................................................................... 7
2.2.2 Commitments of the Government ............................................................................................................. 7
LIST OF ABBREVIATIONS .................................................................................................. 8
ANNEX ..................................................................................................................................... 9
1
Introduction
This document constitutes the Biennial Collaborative Agreement (BCA) between the World Health Organization (WHO) Regional Office for Europe and the Ministry of Health of Latvia, on behalf of its Government, for the biennium 2018–2019. This 2018–2019 BCA is aligned with the WHO Twelfth General Programme of Work, for the period 2014–2019, which has been formulated in the light of the lessons learned during the period covered by the Eleventh General Programme of Work. It provides a high‐level strategic vision for the work of WHO, establishes priorities and provides an overall direction for the six‐year period beginning in January 2014. It reflects the three main components of WHO reform: programmes and priorities, governance and management. The WHO Programme Budget 2018–2019, as approved by the Seventieth World Health Assembly in resolution WHA70.5, was strongly shaped by Member States, which have reviewed and refined the priority-setting mechanisms and the five technical categories and one managerial category by which the work of the Organization is now structured. The BCA reflects the vision of the WHO Regional Office for Europe, Better Health for Europe, as well as the concepts, principles and values underpinning the European policy framework for health and well-being, Health 2020, adopted by the WHO Regional Committee for Europe at its 62nd session. Health 2020 seeks to maximize opportunities for promoting population health and reducing health inequities. It recommends that European countries address population health through whole-of-society and whole-of-government approaches. Health 2020 emphasizes the need to improve overall governance for health and proposes paths and approaches for more equitable, sustainable and accountable health development. As such, Health 2020 is the unifying policy framework for the collective effort to achieve the new 2030 Agenda for Sustainable Development by promoting inclusive and participatory governance, adopting a whole-of-government/whole-of-society approach and strategically mobilizing and using resources. Health 2020’s intersectoral approach of health in all policies means health in all the Sustainable Development Goals (SDGs) of the 2030 Agenda. Contributing to all the goals of the 2030 Agenda by leading and steering the integration of the health objectives and priority areas for action into the 2030 Agenda process, implementation of Health 2020 will provide a resilient and supportive environment that will enable the achievement of SDG 3 on ensuring healthy lives and promoting well-being for all at all ages as well as the health targets in all the other SDGs. Description of the Biennial Collaborative Agreement This document constitutes a practical framework for collaboration. It has been drawn up in a process of successive consultations between national health authorities and the Secretariat of the WHO Regional Office for Europe. The collaboration programme for 2018–2019 has taken its point of departure from the bottom-up planning process for 2018–2019 undertaken with the country. This work was carried out as part of WHO reform, in the overall context provided by the Twelfth General Programme of Work. The objective of the bottom-up planning exercise was to determine the priority health outcomes for WHO collaboration with the country during the period 2018–2019. This
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document further details the collaboration programme, including proposed outputs and deliverables. The WHO Secretariat has managerial responsibility and is accountable for the programme budget outputs, while the outcomes define Member States’ uptake of these outputs. Achieving the programme budget outcomes is the joint responsibility of the individual Member State and the Secretariat. At the highest level of the results chain, the outcomes contribute to the overall impact of the Organization, namely, sustainable changes in the health of populations, to which the Secretariat and the countries contribute. Achieving the priority outcomes as identified in this BCA is therefore the responsibility of both the WHO Secretariat and the Government of Latvia. The document is structured as follows:
1. PART 1 covers the health impacts that it is hoped will be achieved through the agreed programme for collaboration in 2018–2019, which will be the focus of the joint efforts of the Government and the WHO Secretariat. Summaries by programme budget category, outcomes, programme budget outputs and deliverables and mode of delivery are included. Two modes of delivery are foreseen:
- intercountry, addressing countries’ common needs using Region-wide
approaches. It is expected that an increasing proportion of the work will be delivered in this way.
- country-specific, for outputs that are highly specific to the needs and circumstances of individual countries. This will continue to be important and the chosen mode of delivery in many cases.
2. PART 2 includes sections on the budget for the BCA, its financing and the mutual
commitments of the WHO Secretariat and the Government.
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Terms of collaboration
The priorities (PART 1) provide a framework for collaboration for 2018–2019. The collaborative programme may be revised or adjusted during the course of the biennium by mutual agreement, where prevailing circumstances indicate a need for change. The biennial programme budget outputs and agreed deliverables for 2018–2019 may be amended by mutual agreement in writing between the WHO Regional Office for Europe and the Government as a result of, for example, changes in the country’s health situation, changes in the country capacity to implement the agreed activities, specific needs emerging during the biennium, changes in the Regional Office’s capacity to provide the agreed outputs, or in the light of changes in funding. Either party may initiate amendments. After the BCA is signed, the Ministry of Health will reconfirm/nominate WHO national counterpart and national technical focal points. The national counterpart will be responsible for the overall implementation of the BCA on the part of the Ministry and liaise with all national technical focal points on a regular basis. The Head of WHO Country Office (HWO) will be responsible for implementation of the BCA on behalf of WHO. The BCA workplan, including the planned programme budget outputs, deliverables and implementation schedule, will be agreed accordingly. Implementation will start at the beginning of the biennium 2018–2019. The Regional Office will provide the highest possible level of technical assistance to the country, facilitated and supported by the Country Office or other modalities present in the country. The overall coordination and management of the BCA workplan is the responsibility of the HWO. The WHO budget allocation for the biennium indicates the estimated costs of providing the planned outputs and deliverables, predominantly at the country level. On the basis of the outcome of the WHO financing dialogue, the funding will come from both WHO corporate resources and any other resources mobilized through WHO. These funds should not be used to subsidize or fill financing gaps in the health sector, to supplement salaries or to purchase supplies. Purchases of supplies and donations within crisis response operations or as part of demonstration projects will continue to be funded through additional mechanisms, in line with WHO rules and regulations. The value of WHO technical and management staff based in the Regional Office and in geographically dispersed offices (GDOs), and the input of the Country Office to the delivery of planned outputs and deliverables are not reflected in the indicated budget; the figures therefore greatly understate the real value of the support to be provided to the country. This support goes beyond the indicated budget and includes technical assistance and other inputs from WHO headquarters, the Regional Office, GDOs and unfunded inputs from country offices. The budget and eventual funding included in this Agreement are the Organization’s funds allocated for Regional Office cooperation within the country workplan. The value of Government input – other than that channelled through the WHO Secretariat – is not estimated in the BCA. It should also be noted that this BCA is open to further development and contributions from other sources, in order to supplement the existing programme or to introduce activities that have not been included at this stage. In particular, the WHO Regional Office for Europe will facilitate coordination with WHO headquarters in order to maximize the effectiveness of country interventions in the spirit of the “One WHO” principle.
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PART 1. Setting priorities for collaboration for 2018–2019
1.1 Health situation analysis
Life expectancy at birth has increased in Latvia by almost 5 years since 1980, albeit with substantial discrepancy between men and women. According to the State Statistic Office of Latvia in 2015 life expectancy for men was 68.8 years, while that for women was 78.4 years. In Latvia, similar to many other European countries, the main causes of death are diseases of the circulatory system, which are still considerably more prevalent on average than in countries of the European Union. Malignant neoplasms have been the second most common cause for mortality in the last couple of decades both for males and females. Deaths attributable to external causes (injury or poisoning) remains the third most important cause of death but it is much more frequent amongst males than females. Yet, external cause mortality in Latvia has seen a very strong decline over last ten years. . Similar to other European countries, infectious diseases do not cause high mortality in Latvia. However, mortality from HIV/AIDS in Latvia is among the highest in Europe and has been on a continuous rise since the year 2000. Latvia has made good progress in controlling tuberculosis. The immunization policy is well-implemented and well-functioning, however, both surveillance and strategies need to be strengthened, especially in the area of measles, rubella, diphtheria and in prevention and control of polio. Risk factors for circulatory system diseases, such as unhealthy habits and behaviour (high rate of smoking, unbalanced diet, low physical activity and consequently high body mass index) remain highly prevalent in Latvia. In addition, the incidence of diabetes mellitus, another risk factor for diseases of the circulatory system, has increased more than twice since the year 2000. During the last decade indicators of perinatal care have improved, and perinatal mortality has decreased. However, perinatal and infant mortality remain comparatively high in Latvia and are still much higher than the EU average. Maternal mortality remains comparatively high for the small population, where every death impacts the mortality rate substantially. The Latvian health care system has undergone a remarkable process of transformation in the over twenty-five years since independence. Latvia has universal population coverage of health care. However, Latvia needs to improve financial protection against the cost of ill health. Out-of-pocket payments for health in Latvia are among the highest in Europe and put a high economic burden on individuals. Financial hardship is heavily concentrated among poor households and pensioners and is largely driven by out-of-pocket payments for medicines. Over the last decade, and particularly in recent years, health sector reforms have taken place in Latvia and have aimed at strengthening the primary health care, improving the efficiency of hospitals, rationalizing the use of medicines, creating united emergency care and protecting the poor. A number of strategic documents have been developed and implemented over the last decade in order to address public health threats. In 2014 a new public health strategy with a strong intersectoral and health in all policies approaches was launched by the government for 2014–2020.
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1.2 Priorities for collaboration
1.2.1 Health 2020 and the 2030 Agenda in Latvia
Latvia is highly committed to bringing the Health 2020 vision forward through implementation of the national public health strategy and through sub-national policy development. The Public Health Strategy of Latvia 2014-2020 contributes to the Latvia 2030 strategyg which was launched by the Government of Latvia in February 2017 and which supports Sustainable Development Goals (SDG). The strategic collaboration between Latvia and the WHO Regional Office for Europe will focus on strengthening governance for health through whole-of-government and intersectoral approaches with focus on non-communicable diseases, communicable diseases, mental health, and strengthening of the health system. These are key in supporting the health policy development process and informing the priorities, objectives and activities for policy implementation. The vision of Health 2020 and the 2030 Agenda will be applied by assuring a life-course approach and by supporting Latvia in strengthening policy research and evidence relating to social determinants of health and health equity. Within this BCA WHO will support Latvia in addressing the above challenges by providing technical expertise and capacity building in the area of health system strengthening within the context of universal health coverage and patient’s centred health system through knowledge generation, management and application for national policies actions. The collaboration will complement Latvia’s commitment to the 2018 Voluntary National review of the High-level Political Forum on Sustainable Development.
1.2.2 Linkage of BCA with national and international strategic frameworks for
Latvia
This BCA supports the implementation of Latvia’s national health policies and plans, namely the Public Health Strategy of Latvia 2014-2020, which is based on Health 2020 principles and values with strong focus on cross- sectoral collaboration. Non-communicable diseases (with strong focus on cardio-vascular diseases and cancer), mental health and maternal and child health have been identified as main priorities of the Ministry of Health of Latvia for the period up to 2020, with specific attention on health promotion and healthy life-styles where a major part of EU structural funds available for health will be used, in addition to national resources.
This BCA has already identified the related key SDG targets and indicators and supports the realization of the Public Health Strategy of Latvia 2014-2020.
1.2.3 Programmatic priorities for collaboration
The collaboration programme for 2018–2019 as detailed in the Annex is based on the country-specific needs and WHO regional and global initiatives and perspectives and was mutually agreed and selected in response to public health concerns and ongoing efforts to improve the
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health status of the population of Latvia. It seeks to facilitate strategic collaboration enabling WHO to make a unique contribution. The programme budget outputs and deliverables are subject to further amendments as stipulated in the Terms of Collaboration of the BCA. A linkage to the related SDG target and Health 2020 targets is provided for every programme budget output.
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PART 2. Budget and commitments for 2018–2019
2.1 Budget and financing
The total budget of the Latvia BCA is US$ 150 000. All sources of funds will be employed to fund this budget. In accordance with World Health Assembly resolution WHA70.5, following the financing dialogue the Director-General will make known the distribution of available funding, after which the Regional Director can consider the Regional Office’s allocations to the biennial collaborative agreements. The value of the WHO contribution goes beyond the indicated monetary figures in this document, since it includes technical assistance and other inputs from WHO headquarters, the Regional Office, GDOs and country offices (COs). The WHO Secretariat will, as part of its annual and biennial programme budget implementation report to the Regional Committee, include an estimate of the actual costs of the country programme, including, in quantitative terms, the full support provided to countries by the Regional Office, in addition to amounts directly budgeted in the country workplans.
2.2 Commitments
The Government and the WHO Secretariat jointly commit to working together to mobilize the additional funds required to achieve the outcomes, programme budget outputs and deliverables defined in this BCA.
2.2.1 Commitments of the WHO Secretariat
WHO agrees to provide, subject to the availability of funds and its rules and regulations, the outputs and deliverables defined in this BCA. Separate agreements will be concluded for any local cost subsidy or direct financial cooperation inputs at the time of execution.
2.2.2 Commitments of the Government
The Government shall engage in the policy and strategy formulation and implementation processes required and provide available personnel, materials, supplies, equipment and local expenses necessary for the achievement of the outcomes identified in the BCA.
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LIST OF ABBREVIATIONS
General abbreviations
AC – assessed contributions
BCA – Biennial Collaborative Agreement CO – Country Office CS – Country-specific EURO – WHO Regional Office for Europe GDO – geographically dispersed office HWO – Head of WHO Country Office IC – Intercountry
MoE – Ministry of Education MoF – Ministry of Finance MoH – Ministry of Health
MoI – Ministry of Interior MoW – Ministry of Welfare NHS - National Health Service
PB – Programme budget RO – Regional Office SDG – Sustainable Development Goals
Technical abbreviations
ARV – antiretroviral (medicines) CAH – child and adolescent health development
EU – European Union HBSC – Health Behaviour in School-aged Children
IHR - International Health Regulations M/XDR-TB multidrug - and extensively drug-resistant tuberculosis NC – national counterpart NCDs noncommunicable diseases
NFPs - national focal points NHPSP - National health policies, strategies and plans PHC – primary health care
SDH/HI - social determinants of health and inequities WHO FCTC - WHO Framework Convention on Tobacco Control
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rda
ble
me
asu
res/
too
ls t
o m
on
ito
r a
nd
to
red
uce
Alc
oh
ol
risk
fa
cto
rs i
n L
atv
ia.
SD
GR
efe
ren
ce:
03
04
01
CS
MO
E,
MO
F,D
ise
ase
Pre
ve
nti
on
an
d
Co
ntr
ol
Ce
nte
r
2.2
Me
nta
l h
ea
lth
an
d
sub
sta
nce
ab
use
2.2
.1.
Co
un
trie
s’ c
ap
aci
ty s
tre
ng
the
ne
d t
o d
ev
elo
p
an
d i
mp
lem
en
t n
ati
on
al
po
lici
es,
pla
ns
an
d
info
rma
tio
n s
yst
em
s in
lin
e w
ith
th
e
com
pre
he
nsi
ve
me
nta
l h
ea
lth
act
ion
pla
n
20
13
–2
02
0 a
nd
oth
er
go
ve
rnin
g b
od
y r
eso
luti
on
s
an
d a
ctio
n p
lan
s
3.4
By
20
30
, re
du
ce b
y o
ne
thir
d p
rem
atu
re m
ort
ali
ty
fro
m n
on
-co
mm
un
ica
ble
dis
ea
ses
thro
ug
h
pre
ve
nti
on
an
d t
rea
tme
nt
an
d p
rom
ote
me
nta
l h
ea
lth
an
d w
ell
-be
ing
T2
-In
cre
ase
life
exp
ect
an
cy
in E
uro
pe
22
1C
1 W
ork
wit
h p
art
ne
rs t
o s
up
po
rt t
he
de
ve
lop
me
nt
an
d i
mp
lem
en
tati
on
of
na
tio
na
l
me
nta
l h
ea
lth
po
lici
es,
la
ws
an
d r
eg
ula
tio
ns
an
d
pla
ns
in l
ine
wit
h r
eg
ion
al
an
d g
lob
al
me
nta
l
he
alt
h a
ctio
n p
lan
s a
nd
hu
ma
n r
igh
ts s
tan
da
rds.
Su
pp
ort
th
e d
ev
elo
pm
en
t a
nd
im
ple
me
nta
tio
n o
f
me
nta
l h
ea
lth
in
La
tvia
. S
DG
Re
fere
nce
: 0
30
4X
X
CS
Dis
ea
se
Pre
ve
nti
on
an
d
Co
ntr
ol
Ce
nte
r
2.3
Vio
len
ce a
nd
inju
rie
s
2.3
.3.
De
ve
lop
me
nt
an
d i
mp
lem
en
tati
on
of
po
lici
es
an
d p
rog
ram
me
s to
ad
dre
ss v
iole
nce
ag
ain
st w
om
en
, y
ou
ng
pe
op
le a
nd
ch
ild
ren
faci
lita
ted
16
.1 S
ign
ific
an
tly
re
du
ce a
ll
form
s o
f v
iole
nce
an
d
rela
ted
de
ath
ra
tes
ev
ery
wh
ere
T1
-Re
du
ce
pre
ma
ture
mo
rta
lity
in
the
Eu
rop
e
by
20
20
23
3C
1 S
tre
ng
the
n c
ou
ntr
y c
ap
aci
ty t
o d
ev
elo
p a
nd
imp
lem
en
t p
rog
ram
me
s th
at
ad
dre
ss v
iole
nce
ag
ain
st c
hil
dre
n,
wo
me
n a
nd
yo
un
g p
eo
ple
, a
nd
mo
nit
or
the
ir i
mp
lem
en
tati
on
.
Co
nti
nu
ed
su
pp
ort
pro
vid
ed
at
na
tio
na
l a
nd
su
b-
na
tio
na
l le
ve
ls t
o a
dd
ress
vio
len
ce a
ga
inst
ch
ild
ren
,
wo
me
n a
nd
yo
uth
th
rou
gh
str
en
gth
en
ing
of
cro
ss-
sect
ora
l w
ork
s in
La
tvia
. S
DG
Re
fere
nce
: 1
60
10
1
CS
MO
E,
MO
W,D
ise
ase
Pre
ve
nti
on
an
d
Co
ntr
ol
Ce
nte
r
Pro
gra
mm
e A
rea
9
Ou
tpu
tP
rim
ary
SD
G T
arg
et
Pri
ma
ry
H2
02
0
Ta
rge
t
PB
De
liv
era
ble
te
xt
BC
A P
rod
uct
an
d S
erv
ice
Mo
de
of
De
liv
ery
Oth
er
Go
ve
rnm
en
t
Se
cto
rs
Pro
gra
mm
e A
rea
3.5
He
alt
h a
nd
th
e
en
vir
on
me
nt
3.5
.1.
Co
un
try
ca
pa
city
en
ha
nce
d t
o a
sse
ss h
ea
lth
risk
s a
nd
to
de
ve
lop
an
d i
mp
lem
en
t p
oli
cie
s,
stra
teg
ies
or
reg
ula
tio
ns
for
the
pre
ve
nti
on
,
mit
iga
tio
n a
nd
ma
na
ge
me
nt
of
the
he
alt
h i
mp
act
s
of
en
vir
on
me
nta
l a
nd
occ
up
ati
on
al
risk
s
11
.6 B
y 2
03
0,
red
uce
th
e
ad
ve
rse
pe
r ca
pit
a
en
vir
on
me
nta
l im
pa
ct o
f
citi
es,
in
clu
din
g b
y p
ay
ing
spe
cia
l a
tte
nti
on
to
air
qu
ali
ty a
nd
mu
nic
ipa
l a
nd
oth
er
wa
ste
ma
na
ge
me
nt
T1
-Re
du
ce
pre
ma
ture
mo
rta
lity
in
the
Eu
rop
e
by
20
20
35
1C
1 E
nh
an
ce,
as
a r
esu
lt o
f W
HO
te
chn
ica
l
sup
po
rt,
na
tio
na
l a
nd
su
bn
ati
on
al
cap
aci
ty t
o
en
ga
ge
in
eff
ect
ive
cro
ss-s
ect
ora
l co
ord
ina
tio
n f
or
en
vir
on
me
nt,
la
bo
ur
an
d h
ea
lth
, a
sse
ss a
nd
ma
na
ge
th
e h
ea
lth
im
pa
cts
of
en
vir
on
me
nta
l
risk
s, i
ncl
ud
ing
th
rou
gh
he
alt
h i
mp
act
ass
ess
me
nts
, a
nd
su
pp
ort
th
e d
ev
elo
pm
en
t o
f
na
tio
na
l p
oli
cie
s a
nd
pla
ns
on
en
vir
on
me
nta
l a
nd
wo
rke
rs’
he
alt
h.
Te
chn
ica
l su
pp
ort
to
en
ha
nce
na
tio
na
l a
nd
sub
na
tio
na
l ca
pa
city
to
ass
ess
an
d m
an
ag
e h
ea
lth
imp
act
s o
f a
nd
en
ga
ge
in
cro
ss-s
ect
ora
l
coll
ab
ora
tio
n t
o d
ev
elo
p a
nd
im
ple
me
nt
po
lici
es
an
d p
lan
s a
dd
ress
ing
air
qu
ali
ty i
n s
cho
ol.
SD
GR
efe
ren
ce:
11
06
02
CS
MO
E,
He
alt
h
Insp
ect
ion
4.1
Na
tio
na
l h
ea
lth
po
lici
es,
str
ate
gie
s
an
d p
lan
s
4.1
.1.
Imp
rov
ed
co
un
try
go
ve
rna
nce
ca
pa
city
to
form
ula
te,
imp
lem
en
t a
nd
re
vie
w c
om
pre
he
nsi
ve
na
tio
na
l h
ea
lth
po
lici
es,
str
ate
gie
s a
nd
pla
ns
(in
clu
din
g m
ult
ise
cto
ral
act
ion
, a
“H
ea
lth
in
All
Po
lici
es”
ap
pro
ach
an
d e
qu
ity
po
lici
es)
3.8
Ach
iev
e u
niv
ers
al
he
alt
h c
ov
era
ge
, in
clu
din
g
fin
an
cia
l ri
sk p
rote
ctio
n,
acc
ess
to
qu
ali
ty e
sse
nti
al
he
alt
h-c
are
se
rvic
es
an
d
acc
ess
to
sa
fe,
eff
ect
ive
,
qu
ali
ty a
nd
aff
ord
ab
le
ess
en
tia
l m
ed
icin
es
an
d
va
ccin
es
for
all
T5
-Un
ive
rsa
l
cov
era
ge
an
d
the
“ri
gh
t to
he
alt
h”
41
1C
1 F
aci
lita
te t
he
de
ve
lop
me
nt
an
d
imp
lem
en
tati
on
of
com
pre
he
nsi
ve
na
tio
na
l h
ea
lth
po
lici
es/
stra
teg
ies/
pla
ns
ap
ply
ing
WH
O t
oo
ls a
nd
ap
pro
ach
es
tha
t e
nsu
re a
nd
/or
pro
mo
te t
he
resi
lie
nce
of
he
alt
h s
yst
em
s a
nd
a r
igh
ts-b
ase
d
ap
pro
ach
, re
spe
ct n
ati
on
al
ow
ne
rsh
ip,
giv
e a
vo
ice
to
th
e p
op
ula
tio
n,
imp
rov
e a
cco
un
tab
ilit
y
an
d p
oli
cy c
oh
ere
nce
, a
nd
are
in
lin
e w
ith
th
e
pri
nci
ple
s o
f co
un
try
ow
ne
rsh
ip o
f th
e
de
ve
lop
me
nt
ag
en
da
an
d s
tew
ard
ship
of
the
he
alt
h s
yst
em
pro
mo
ted
by
th
e I
nte
rna
tio
na
l
He
alt
h P
art
ne
rsh
ip f
or
UH
C 2
03
0.
Co
nti
nu
ed
te
chn
ica
l su
pp
ort
to
La
tvia
th
rou
gh
WH
O/B
alt
ic P
oli
cy D
ialo
gu
e S
DG
Re
fere
nce
: 0
30
8X
X
ICN
HS
, D
ise
ase
Pre
ve
nti
on
an
d
Co
ntr
ol
Ce
nte
r
4.1
Na
tio
na
l h
ea
lth
po
lici
es,
str
ate
gie
s
an
d p
lan
s
4.1
.2.
Imp
rov
ed
na
tio
na
l h
ea
lth
fin
an
cin
g
stra
teg
ies
aim
ed
at
mo
vin
g t
ow
ard
s u
niv
ers
al
he
alt
h c
ov
era
ge
3.8
Ach
iev
e u
niv
ers
al
he
alt
h c
ov
era
ge
, in
clu
din
g
fin
an
cia
l ri
sk p
rote
ctio
n,
acc
ess
to
qu
ali
ty e
sse
nti
al
he
alt
h-c
are
se
rvic
es
an
d
acc
ess
to
sa
fe,
eff
ect
ive
,
qu
ali
ty a
nd
aff
ord
ab
le
ess
en
tia
l m
ed
icin
es
an
d
va
ccin
es
for
all
T3
-Re
du
ce
ine
qu
itie
s in
he
alt
h i
n
Eu
rop
e
(so
cia
l
de
term
ina
nts
targ
et)
41
2C
1 F
aci
lita
te c
ou
ntr
y-l
ev
el
ad
vo
cacy
fo
r, a
nd
po
licy
on
, n
ati
on
al
he
alt
h f
ina
nci
ng
po
lici
es/
stra
teg
ies
to s
ust
ain
pro
gre
ss t
ow
ard
s th
e
att
ain
me
nt
of
targ
et
3.8
(u
niv
ers
al
he
alt
h
cov
era
ge
) u
nd
er
the
Su
sta
ina
ble
De
ve
lop
me
nt
Go
als
.
Co
nti
nu
ed
te
chn
ica
l a
ssis
tan
ce i
n h
ea
lth
fin
an
cin
g
incl
ud
ing
im
ple
me
nta
tio
n o
f N
ord
DR
G s
yst
em
in
Latv
ia a
nd
co
nti
nu
ed
su
pp
ort
on
str
en
gth
en
ing
of
na
tio
na
l ca
pa
city
. S
DG
Re
fere
nce
: 0
30
8X
X
CS
NH
S
4.2
Inte
gra
ted
pe
op
le-
cen
tre
d h
ea
lth
serv
ice
s
4.2
.1.
Eq
uit
ab
le i
nte
gra
ted
, p
eo
ple
-ce
ntr
ed
serv
ice
de
liv
ery
sy
ste
ms
in p
lace
in
co
un
trie
s a
nd
pu
bli
c h
ea
lth
ap
pro
ach
es
stre
ng
the
ne
d
3.8
Ach
iev
e u
niv
ers
al
he
alt
h c
ov
era
ge
, in
clu
din
g
fin
an
cia
l ri
sk p
rote
ctio
n,
acc
ess
to
qu
ali
ty e
sse
nti
al
he
alt
h-c
are
se
rvic
es
an
d
acc
ess
to
sa
fe,
eff
ect
ive
,
qu
ali
ty a
nd
aff
ord
ab
le
ess
en
tia
l m
ed
icin
es
an
d
va
ccin
es
for
all
T3
-Re
du
ce
ine
qu
itie
s in
he
alt
h i
n
Eu
rop
e
(so
cia
l
de
term
ina
nts
targ
et)
42
1C
4 P
rov
ide
su
pp
ort
fo
r d
eli
ne
ati
ng
th
e r
ole
an
d i
mp
rov
ing
th
e p
erf
orm
an
ce o
f p
rim
ary
,
ho
spit
al,
lo
ng
-te
rm,
com
mu
nit
y a
nd
ho
me
-ba
sed
care
se
rvic
es
wit
hin
in
teg
rate
d,
pe
op
le-c
en
tre
d
he
alt
h s
erv
ice
de
liv
ery
sy
ste
ms,
an
d s
tre
ng
the
nin
g
em
erg
en
cy a
nd
ess
en
tia
l su
rgic
al
care
an
d
an
ae
sth
esi
a,
incl
ud
ing
str
en
gth
en
ing
th
eir
go
ve
rna
nce
, a
cco
un
tab
ilit
y,
ma
na
ge
me
nt,
qu
ali
ty
an
d s
afe
ty,
an
d f
or
resp
on
din
g e
ffe
ctiv
ely
to
em
erg
en
cie
s a
nd
dis
ast
ers
.
Su
pp
ort
La
tvia
to
mo
nit
or
pe
rfo
rma
nce
of
he
alt
h
serv
ice
s d
eli
ve
ry.
SD
GR
efe
ren
ce:
03
08
01
CS
NH
S
4.2
Inte
gra
ted
pe
op
le-
cen
tre
d h
ea
lth
serv
ice
s
4.2
.3.
Co
un
trie
s e
na
ble
d t
o i
mp
rov
e p
ati
en
t sa
fety
an
d q
ua
lity
of
serv
ice
s, a
nd
pa
tie
nt
em
po
we
rme
nt
wit
hin
th
e c
on
text
of
un
ive
rsa
l h
ea
lth
co
ve
rag
e
3.8
Ach
iev
e u
niv
ers
al
he
alt
h c
ov
era
ge
, in
clu
din
g
fin
an
cia
l ri
sk p
rote
ctio
n,
acc
ess
to
qu
ali
ty e
sse
nti
al
he
alt
h-c
are
se
rvic
es
an
d
acc
ess
to
sa
fe,
eff
ect
ive
,
qu
ali
ty a
nd
aff
ord
ab
le
ess
en
tia
l m
ed
icin
es
an
d
va
ccin
es
for
all
T1
-Re
du
ce
pre
ma
ture
mo
rta
lity
in
the
Eu
rop
e
by
20
20
42
3C
1 I
de
nti
fy n
ati
on
al
cap
aci
ty-s
tre
ng
the
nin
g
ne
ed
s a
nd
su
pp
ort
Me
mb
er
Sta
tes
in i
mp
rov
ing
the
qu
ali
ty a
nd
sa
fety
of
he
alt
h s
erv
ice
s, t
hro
ug
h
reg
ula
tio
n,
acc
red
ita
tio
n a
nd
me
asu
rem
en
t o
f
ou
tco
me
s.
Su
pp
ort
co
un
trie
s in
de
ve
lop
ing
an
d i
mp
lem
en
tin
g
po
lici
es
an
d i
nit
iati
ve
s fo
r im
pro
vin
g q
ua
lity
of
care
, in
clu
ing
pa
tie
nt
safe
ty.
SD
GR
efe
ren
ce:
03
08
01
CS
NH
S,
Dis
ea
se
Pre
ve
nti
on
an
d
Co
ntr
ol
Ce
nte
r
10
Ou
tpu
tP
rim
ary
SD
G T
arg
et
Pri
ma
ry
H2
02
0
Ta
rge
t
PB
De
liv
era
ble
te
xt
BC
A P
rod
uct
an
d S
erv
ice
Mo
de
of
De
liv
ery
Oth
er
Go
ve
rnm
en
t
Se
cto
rs
Pro
gra
mm
e A
rea
4.3
Acc
ess
to
me
dic
ine
s a
nd
oth
er
he
alt
h
tech
no
log
ies
an
d
stre
ng
the
nin
g
reg
ula
tory
ca
pa
city
4.3
.1.
Acc
ess
to
an
d u
se o
f e
sse
nti
al
me
dic
ine
s
an
d o
the
r h
ea
lth
te
chn
olo
gie
s im
pro
ve
d t
hro
ug
h
glo
ba
l g
uid
an
ce a
nd
th
e d
ev
elo
pm
en
t a
nd
imp
lem
en
tati
on
of
na
tio
na
l p
oli
cie
s, s
tra
teg
ies
an
d t
oo
ls
3.8
Ach
iev
e u
niv
ers
al
he
alt
h c
ov
era
ge
, in
clu
din
g
fin
an
cia
l ri
sk p
rote
ctio
n,
acc
ess
to
qu
ali
ty e
sse
nti
al
he
alt
h-c
are
se
rvic
es
an
d
acc
ess
to
sa
fe,
eff
ect
ive
,
qu
ali
ty a
nd
aff
ord
ab
le
ess
en
tia
l m
ed
icin
es
an
d
va
ccin
es
for
all
T5
-Un
ive
rsa
l
cov
era
ge
an
d
the
“ri
gh
t to
he
alt
h”
43
1C
2 S
up
po
rt i
nst
itu
tio
na
liza
tio
n a
nd
ca
pa
city
-
bu
ild
ing
eff
ort
s to
en
ha
nce
su
sta
ina
ble
acc
ess
to
an
d r
ati
on
al
use
of
me
dic
ine
s, v
acc
ine
s a
nd
oth
er
he
alt
h t
ech
no
log
ies,
in
clu
din
g i
n e
me
rge
ncy
an
d
dis
ea
se o
utb
rea
k s
ett
ing
s.
Su
pp
ort
in
stit
uti
on
ali
zati
on
an
d c
ap
aci
ty-b
uil
din
g
eff
ort
s to
en
ha
nce
su
sta
ina
ble
acc
ess
to
an
d
rati
on
al
use
of
me
dic
ine
s, v
acc
ine
s a
nd
oth
er
he
alt
h t
ech
no
log
ies,
in
clu
din
g i
n e
me
rge
ncy
an
d
dis
ea
se o
utb
rea
k s
ett
ing
s.
Su
pp
ort
La
tvia
on
de
ve
lop
me
nt
of
me
dic
al
pro
du
ct
po
lici
es.
SD
GR
efe
ren
ce:
03
08
XX
CS
NH
S
4.4
He
alt
h s
yst
em
s,
info
rma
tio
n a
nd
ev
ide
nce
4.4
.1.
Co
mp
reh
en
siv
e m
on
ito
rin
g o
f th
e g
lob
al,
reg
ion
al
an
d c
ou
ntr
y h
ea
lth
sit
ua
tio
n,
tre
nd
s,
ine
qu
ali
tie
s a
nd
de
term
ina
nts
usi
ng
glo
ba
l
sta
nd
ard
s, i
ncl
ud
ing
da
ta c
oll
ect
ion
an
d a
na
lysi
s
to a
dd
ress
da
ta g
ap
s a
nd
sy
ste
m p
erf
orm
an
ce
ass
ess
me
nt
17
.18
By
20
20
, e
nh
an
ce
cap
aci
ty-b
uil
din
g s
up
po
rt
to d
ev
elo
pin
g c
ou
ntr
ies,
incl
ud
ing
fo
r le
ast
de
ve
lop
ed
co
un
trie
s a
nd
sma
ll i
sla
nd
de
ve
lop
ing
Sta
tes,
to
in
cre
ase
sig
nif
ica
ntl
y t
he
av
ail
ab
ilit
y
of
hig
h-q
ua
lity
, ti
me
ly a
nd
reli
ab
le d
ata
dis
ag
gre
ga
ted
by
in
com
e,
ge
nd
er,
ag
e,
race
, e
thn
icit
y,
mig
rato
ry
sta
tus,
dis
ab
ilit
y,
ge
og
rap
hic
lo
cati
on
an
d
oth
er
cha
ract
eri
stic
s
rele
va
nt
in n
ati
on
al
con
text
s
T5
-Un
ive
rsa
l
cov
era
ge
an
d
the
“ri
gh
t to
he
alt
h”
44
1C
1 R
eg
ula
rly
re
vie
w a
nd
ass
ess
th
e n
ati
on
al
an
d s
ub
na
tio
na
l h
ea
lth
sit
ua
tio
n a
nd
tre
nd
s u
sin
g
com
pa
rab
le m
eth
od
s, t
ak
ing
in
to a
cco
un
t
na
tio
na
l, r
eg
ion
al
an
d g
lob
al
pri
ori
tie
s o
n t
he
Su
sta
ina
ble
De
ve
lop
me
nt
Go
als
, a
nd
en
sure
qu
ali
ty o
f st
ati
stic
s.
Pe
rfo
rm a
sse
ssm
en
t o
f th
e h
ea
lth
in
form
ati
on
syst
em
in
La
tvia
an
d s
up
po
rt i
mp
lem
en
tati
on
of
its
reco
mm
en
da
tio
ns.
S
DG
Re
fere
nce
: 1
71
80
1
CS
Dis
ea
se
Pre
ve
nti
on
an
d
Co
ntr
ol
Ce
nte
r
4.4
He
alt
h s
yst
em
s,
info
rma
tio
n a
nd
ev
ide
nce
4.4
.2.
Co
un
trie
s e
na
ble
d t
o p
lan
, d
ev
elo
p a
nd
imp
lem
en
t a
n e
He
alt
h s
tra
teg
y
17
.8 F
ull
y o
pe
rati
on
ali
ze
the
te
chn
olo
gy
ba
nk
an
d
scie
nce
, te
chn
olo
gy
an
d
inn
ov
ati
on
ca
pa
city
-
bu
ild
ing
me
cha
nis
m f
or
lea
st d
ev
elo
pe
d c
ou
ntr
ies
by
20
17
an
d e
nh
an
ce t
he
use
of
en
ab
lin
g t
ech
no
log
y,
in p
art
icu
lar
info
rma
tio
n
an
d c
om
mu
nic
ati
on
s
tech
no
log
y
T5
-Un
ive
rsa
l
cov
era
ge
an
d
the
“ri
gh
t to
he
alt
h”
44
2C
1 S
up
po
rt c
ap
aci
ty-b
uil
din
g a
nd
pa
rtn
ers
hip
s
in d
ev
elo
pin
g a
nd
im
ple
me
nti
ng
a n
ati
on
al
eH
ea
lth
str
ate
gy
to
im
pro
ve
he
alt
h s
erv
ice
s a
nd
ev
ide
nce
-ba
sed
po
licy
-ma
kin
g,
incl
ud
ing
sh
ifti
ng
to e
lect
ron
ic h
ea
lth
re
cord
s.
Te
chn
ica
l a
ssit
an
ce t
o L
atv
ia i
n i
mp
lem
en
ati
on
of
e-
He
alt
h.
SD
GR
efe
ren
ce:
17
08
XX
CS
NH
S
11
Ou
tpu
tP
rim
ary
SD
G T
arg
et
Pri
ma
ry
H2
02
0
Ta
rge
t
PB
De
liv
era
ble
te
xt
BC
A P
rod
uct
an
d S
erv
ice
Mo
de
of
De
liv
ery
Oth
er
Go
ve
rnm
en
t
Se
cto
rs
Pro
gra
mm
e A
rea
E.2
Co
un
try
He
alt
h
Em
erg
en
cy
Pre
pa
red
ne
ss a
nd
the
In
tern
ati
on
al
He
alt
h R
eg
ula
tio
ns
(20
05
)
E.2
.1.
Co
un
try
co
re c
ap
aci
tie
s fo
r h
ea
lth
em
erg
en
cy p
rep
are
dn
ess
an
d t
he
In
tern
ati
on
al
He
alt
h R
eg
ula
tio
ns
(20
05
) in
de
pe
nd
en
tly
ass
ess
ed
an
d n
ati
on
al
act
ion
pla
ns
de
ve
lop
ed
3.d
Str
en
gth
en
th
e c
ap
aci
ty
of
all
co
un
trie
s, i
n p
art
icu
lar
de
ve
lop
ing
co
un
trie
s, f
or
ea
rly
wa
rnin
g,
risk
red
uct
ion
an
d m
an
ag
em
en
t
of
na
tio
na
l a
nd
glo
ba
l
he
alt
h r
isk
s
T1
-Re
du
ce
pre
ma
ture
mo
rta
lity
in
the
Eu
rop
e
by
20
20
E2
1O
3 C
oo
rdin
ate
an
d s
up
po
rt t
he
pro
cess
of
vo
lun
tary
in
de
pe
nd
en
t m
ult
ise
cto
ral
ev
alu
ati
on
of
cou
ntr
y c
ore
ca
pa
citi
es
an
d i
mp
lem
en
tati
on
of
the
Inte
rna
tio
na
l H
ea
lth
Re
gu
lati
on
s (2
00
5).
De
ve
lop
an
d d
isse
min
ate
re
gu
lar
rep
ort
s o
n t
he
imp
lem
en
tati
on
of
cou
ntr
ies’
co
re c
ap
aci
ty
req
uir
em
en
ts u
nd
er
the
In
tern
ati
on
al
He
alt
h
Re
gu
lati
on
s (2
00
5)
an
d t
he
Se
nd
ai
Fra
me
wo
rk f
or
Dis
ast
er
Ris
k R
ed
uct
ion
20
15
–2
03
0.
Su
pp
ort
th
e
de
ve
lop
me
nt
of
mu
ltis
ect
ora
l n
ati
on
al
act
ion
pla
ns
for
ma
na
gin
g r
isk
s o
f e
me
rge
nci
es
ba
sed
on
ass
ess
me
nts
of
cou
ntr
y c
ap
aci
tie
s a
nd
su
pp
ort
th
e
ma
tch
ing
of
reso
urc
es
to f
ill
crit
ica
l co
re c
ap
aci
ty
ga
ps.
Re
po
rt o
n t
he
im
ple
me
nta
tio
n o
f n
ati
on
al
act
ion
pla
ns.
Su
pp
ort
th
e d
ev
elo
pm
en
t o
f m
ult
ise
cto
ral
na
tio
na
l
act
ion
pla
ns
for
ma
na
gin
g r
isk
s o
f e
me
rge
nci
es
ba
sed
on
ass
ess
me
nts
of
cou
ntr
y c
ap
aci
tie
s a
nd
sup
po
rt t
he
ma
tch
ing
of
reso
urc
es
to f
ill
crit
ica
l
core
ca
pa
city
ga
ps.
SD
GR
efe
ren
ce:
03
0d
01
ICM
OI,
Sta
te
Me
dic
al
Em
erg
en
cy
cen
ter
12
