Ms. Zues has extensive experience supporting ministries of health and national purchasers to design and implement strategic purchasing reforms. She has led the development of service specifications, payment mechanisms, contracting arrangements, and performance monitoring systems under Programs of Medical Guarantees, including reforms for PHC, hospital care, maternal and child health, and noncommunicable diseases. Her work includes designing risk-adjusted capitation models for PHC in Kazakhstan, Kyrgyzstan, and Uzbekistan; leading costing studies for rehabilitation, telemedicine, and TB services in Ukraine and Uzbekistan; and supporting DRG-based hospital payment reforms in Ukraine, Ghana, Vietnam, and Uzbekistan. She has also modeled annual budgets to assess financial risks for providers and purchasing agencies and advised governments on policies related to pooling, provider autonomy, and benefit design. In addition, she has strengthened ministry capacity to coordinate cross-sector reforms within sector-wide approaches (SWAp) and supported the use of costing data and National Health Accounts to inform resource allocation.

Ms. Zues brings deep expertise in TB financing and service delivery reform. She has led TB system mapping and facility-level costing; designed case-based payment models and laboratory payment approaches; and developed incentives to strengthen TB detection and treatment within PHC. She has supported the inclusion of TB services in State Medical Guarantee Programs and the design of TB contracting arrangements for national purchasers. She has also facilitated regional learning exchanges across Eastern Europe and Central Asia to build capacity in TB payment reform and contributed to multi-country assessments in Sub-Saharan Africa to address financial barriers to TB, HIV, and malaria services.

As a senior fellow at Results for Development (R4D), Ms. Zues supports the Rehab4U project, leading a national rehabilitation costing study in Ukraine to inform revisions to payment systems under the Program of Medical Guarantees (PMG) and supporting strategic purchasing dialogue with the National Health Service of Ukraine (NHSU) and development partners.

Publications:

• Estimating Resources Associated with Delivering Telemedicine Services at Facility Level in Ukraine | Local Health System Sustainability Project, 2024
• Ukraine: Review of Health Ukraine Health Financing Reform: Progress and Future Directions. 2022
• Ukraine: Review of Health Financing Reforms 2016–2019: WHO–World Bank Joint Report, 2020

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The global movement for universal health coverage inspires me with its commitment to equity. The way we support this movement also needs to embody the principles of equity — building lateral networks of expertise, engaging in country-led processes with respect and humility, valuing all forms of knowledge and learning, and challenging historical power structures.

Cheryl Cashin, PhD, has more than 30 years of experience in academia, and policy design and implementation, primarily focused on improving knowledge and practice to better leverage health financing for universal health coverage (UHC).

As a managing director at R4D, Dr. Cashin provides strategic and technical leadership for roughly half of the organization’s portfolio of programs and serves on the R4D executive team. Dr. Cashin works with R4D’s practice area leads to create and fund high-impact programs, and oversee their design and implementation. She represents R4D in global forums on health financing and UHC and continues to contribute thought leadership and technical expertise.

Since joining R4D in 2011, Dr. Cashin has been a leader in the global effort to build new models of support for countries to address complex health system issues in the journey toward UHC. She has also supported the development of new health practice areas at R4D that address “next generation” UHC challenges, including integrating disease programs (e.g., malaria, HIV, TB) into mainstream health systems for greater efficiency and effectiveness.

Dr. Cashin is regarded as a master technical facilitator, respected by leaders around the world for her skill in helping to translate evidence and experience from other countries to inform decisions in their own countries. She has pioneered innovative platforms to support collaborative learning, including, among others, the Strategic Purchasing Africa Resource Center and the Learning Network for Countries in Transition, for which R4D serves as the network coordinator.

Before joining R4D, Dr. Cashin served as a health financing policy adviser for a range of countries, including Albania, Georgia, Ghana, Indonesia, Kazakhstan, Uzbekistan, and Vietnam. She has been engaged as a health financing expert by the World Bank, WHO, OECD and other global technical partners, and she is a regular on the faculty of WHO’s global advanced course on health financing. She has held academic positions at Boston University’s School of Public Health and University of California, Berkeley’s Nicholas C. Petris Center on Health Care Markets and Consumer Welfare. Dr. Cashin is the lead author of the book Paying for Performance in Health Care: Implications for Health System Performance and Accountability and is a co-author of several other books, book chapters, and peer-reviewed journal articles on health financing and UHC.

Dr. Cashin has a PhD in economics from the University of Washington, and a master’s degree from Cornell University. She completed her undergraduate studies at Bucknell University, where she majored in chemistry and discovered her passion for economics and public policy. She lives on Shelter Island, NY with her husband and dog, and is also an advocate for UHC legislation in the state.

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Dr. Claeson was the program coordinator for the multisector response to AIDS in the South Asia region at the World Bank and task team leader for HIV operations in India and Afghanistan from 2005 to 2012. From 1998 to 2004, she served as lead public health specialist in the Health, Nutrition and Population Human Development Network at the World Bank. In this role, she contributed to health reform programs in Egypt, Jordan, Nigeria, Uzbekistan, China and the Philippines, including the development of innovative financing instruments such as a new lending instrument for multicountry malaria operations, a regional rapid-results agenda and buy-downs for global public goods.

Dr. Claeson also worked as a medical officer for the World Health Organization’s Global Programme for Control of Diarrhoeal Diseases, both globally and in Ethiopia, where she focused on national immunization and diarrheal disease control. She also worked as a physician in rural district-level clinical practice in Tanzania, Bangladesh and Bhutan.

Dr. Claeson is a commissioner on the Lancet Commission on Adolescent Health and Wellbeing. As a member of the Bellagio Study Group on Child Survival, she participated in the call to action on child survival and co-authored Knowledge Into Action for Child Survival in 2003. She also served as a member of the WHO-UNICEF-Lancet Commission on A Future for the World’s Children and co-authored the World Bank reports The Millennium Development Goals for Health: Rising to the Challenges and Disease Control Priorities in Developing Countries, Second Edition. She was awarded an honorary doctor of medicine degree by the Karolinska Institutet in 2015.

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As many countries pursue universal health coverage in the context of rising incomes and plateauing or declining donor assistance, maintaining and expanding effective coverage of essential immunization services will require careful planning for sustainability within macro-fiscal constraints. The Learning Network for Countries in Transition (LNCT) will bring together practitioners from transitioning countries and development partners to learn from each other around specific Gavi transition-related challenges that exist within broader health system and UHC reform processes.

“Peer learning is an effective and efficient approach for supporting implementation across multiple countries. It responds to the immediate needs of countries and produces practical tools that are likely to be utilized,” said Gina Lagomarsino, president and CEO at Results for Development. “We’ve seen success with this approach through our work on other peer-to-peer learning network models, and hope to build a similarly active and engaged community of experts through this new platform.”

In the coming years, significant increases in domestic financing for immunization programs will be needed to expand and sustain immunization programs in low- and lower-middle-income countries. As a country’s economy grows, it crosses Gavi’s eligibility threshold and begins to transition out of support. Transitioning countries often face challenges in achieving high and equitable immunization coverage, and in planning, budgeting and securing adequate financing of their immunization program after Gavi support ends. Insufficient planning can lead to gaps in vaccine coverage, which in turn result in a rise of vaccine-preventable deaths and debilitating illnesses.

For Gavi-transitioning countries, LNCT offers the opportunity to share transition planning and implementation experience, work together to solve common problems, and add to a global knowledge base of tools and approaches that contribute to successful transition. For development partners, this platform offers the chance to engage across countries on transition-related issues. LNCT will consist of both in-person and virtual engagements. The initial cohort of platform members will draw from 13 invited countries in various stages of Gavi transition, with potential membership expansion in 2018 and 2019.

“The ultimate goal of this platform is to improve sustainability of national immunization programs,” said Meghan O’Connell, program officer and LNCT project lead at Results for Development. “More immediately, though, participation can help countries tackle specific technical challenges related to Gavi transition. This will reduce the chance that vaccines will be dropped after a country transitions away from Gavi support, increase the chance that coverage will be maintained or increased and ensure that countries have the skills and ability to introduce new vaccines in the future.”

The platform, which is funded by the Bill & Melinda Gates Foundation, will host its inaugural meeting in May to identify technical topics that can then be taken forward by the relevant countries for more focused engagement. The countries that will be represented at the launch meeting include Armenia, Congo, Georgia, Ghana, Indonesia, Lao People’s Democratic Republic, Moldova, Sudan, Sri Lanka, Timor Leste, Uzbekistan and Vietnam.

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The network — known simply as Linked — is co-led by Results for Development (R4D), the Tbilisi, Georgia-based Curatio International Foundation and the Sri Lanka-based Institute for Health Policy.

The network is a foundational part of the Gavi 5.0 strategy, which focuses on reaching “zero-dose” children and missed communities. Estimates suggest that by 2030, 70% of the world’s under-immunized populations will live in middle-income countries. Linked is one of the core mechanisms through which Gavi connects with, supports and influences key immunization change agents across 24 middle-income countries who have graduated from or never received Gavi’s financial assistance.

Since 2019, Linked has convened immunization practitioners, policymakers and partners from middle-income countries for a facilitated process designed to allow them to share experiences, identify common challenges to immunization programs and tap into one another’s implementation knowledge. Linked supports countries as they translate those learnings into locally driven solutions that are equitable, resilient and sustainable.

“We are so pleased that Gavi recognizes the benefits of this relatively low-cost approach to engaging immunization program leaders across many countries and supporting them to drive their own progress. We are delighted to continue our collaboration with Gavi,” R4D CEO Gina Lagomarsino said.

Linked’s two-year extension will build upon the network’s initial successes, which were catalogued in an impact brief. This brief offers evidence of meaningful policy and program impact through the Linked network.

“At R4D, we have been honing our collaborative learning approaches over the past 15 years. We’re thrilled that Linked has provided solid evidence that collaborative learning contributes to critical health outcomes,” said Program Director Elizabeth Ohadi.

Linked Impact Brief

Discover how Linked's collaborative learning approach is accelerating countries' progress toward improving access to lifesaving vaccines.

Read more

Eleven Linked member countries have developed plans to translate learnings from Linked engagements to actions which strengthen their immunization programs — and nearly 90% of network countries with an action plan say they have made progress in implementation.

The learnings from Linked engagements have supported countries to strengthen the implementation of immunization program activities to improve coverage and equity, including the development of a cost-effectiveness study for the introduction of the HPV vaccine in Tunisia; strengthening the interpersonal communication skills of immunization providers in Uzbekistan; the development and operationalization of a strategy for caregiver education in Vietnam; and the integration of a zero-dose reporting mechanism in the national immunization registry in Armenia.

In a 2023 member survey, 100% of Linked member countries reported being highly satisfied with the technical quality of learning activities and resources, and more than two-thirds (71%) agreed that Linked has contributed to their progress toward sustainable and equitable immunization coverage and the sustainable introduction of new vaccines.

“Facilitating knowledge transfer and peer-to-peer exchange of good practices and lessons learned is a proven way to drive better immunization performance, as demonstrated by Linked,” said Ivdity Chikovani, research unit director at the Curatio International Foundation. Chikovani is also Linked’s country outreach lead for health policy and systems expertise.

“During the next two years, Linked will continue to provide a learning space between countries from different regions, embracing diversity and innovation,” Chikovani added.

Linked will pilot a new subnational peer learning platform in Indonesia in its next phase. It will also transition its focus from regional engagements to cross-regional and global learning engagements.

Learn more about Linked here.

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About Results for Development
Results for Development (R4D) is a leading nonprofit global development partner. We collaborate with change agents — government officials, civil society leaders and social innovators — supporting them as they navigate complex change processes to achieve large-scale, equitable outcomes in health, education and nutrition. We work with country leaders to diagnose challenges, co-create, innovate and implement solutions built on evidence and diverse stakeholder input, and engage in learning to adapt, iterate and improve. We also strengthen global, regional and country ecosystems to support country leaders with expertise, evidence, and innovations. R4D helps country leaders solve their immediate challenges today, while also strengthening systems and institutions to address tomorrow’s challenges. And we share what we learn so others around the world can achieve results for development too. www.R4D.org

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At Results for Development (R4D), Ms. Vasudevan is a regional Helpdesk lead at the EdTech Hub – a global research partnership led by R4D and partners. Within this role, Ms. Vasudevan supports education decision makers to incorporate evidence based and contextually relevant approaches in EdTech. She manages short term technical assistance requests within the Eastern Europe and Central Asia (ECA) and Eastern and Southern Africa (ESA) regions and leads the management of the Specialist Network. In addition, Ms. Vasudevan supports research on the use of EdTech to improve learning access and outcomes in emergency contexts.

Prior to joining R4D, Sharanya was an education specialist with the World Bank where she provided technical assistance to operational and analytical projects in the ECA and South Asia regions. Her work focused largely on teacher professional development, strategies to increase learning outcomes and equity of service delivery in pre-primary and primary grade classrooms. She has worked on projects in India, South Sudan, Afghanistan, Uzbekistan, Bosnia and Herzegovina, Moldova, Liberia and Timor Leste. Prior to the World Bank, Ms. Vasudevan was an education specialist with the Aga Khan Foundation and led the development and implementation of a civic education curriculum program in Kyrgyzstan. She began her career as a primary school teacher with Teach For India in Mumbai.

Ms. Vasudevan holds a master’s degree in international education policy from the University of Pennsylvania. She is fluent in English and Malayalam and proficient in Hindi.

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