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Toolboxes
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1
A Global Perspective
Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoida
...
ble suffering on a massive scale due to lack of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic palliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
more
Primary health care, as outlined in the 1978 Declaration of Alma-Ata and again 40 years later in the 2018 WHO/UNICEF document A vision for
...
primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals, is a whole-of-government and whole-of-society approach to health that combines the following three components: multisectoral policy and action; empowered people and communities; and primary care and essential public health functions as the core of integrated health services.(1) Primary health care-oriented health systems are health systems organized and operated so as to make the right to the highest attainable level of health the main goal, while maximizing equity and solidarity. They are composed of a core set of structural and functional elements that support achieving universal coverage and access to services that are acceptable to the population and that are equity enhancing. The term “primary care” refers to a key process in the health system that supports first-contact, accessible, continued, comprehensive and coordinated patient-focused care.
more
Operational Framework for Primary Health Care
recommended
The World Health Report 2008: Primary Health Care - Now more than ever
World Health Organization
(2008)
C_WHO
Primary care - Putting people first: This chapter describes how primary care brings promotion an
...
d prevention, cure and care together in a safe, effective and socially productive way at the interface between the population and the health system.
more
Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
Primary health care offers a cost–effective route to achieving universal health cov
...
erage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primary health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
more
A guidance document in simple language for health personnel, setting out their rights and responsibilities in conflict and other situations of violence. It explains how responsibilities and rights f
...
or health personnel can be derived from international humanitarian law, human rights law and medical ethics.The document gives practical guidance on:
- The protection of health personnel, the sick and the wounded; - Standards of practice; - The health needs of particularly vulnerable people; - Health records and transmission of medical records; - "Imported" health care (including military health care);
- Data gathering and health personnel as witnesses to violations of international law; - Working with the media
more
The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health
...
coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism for achieving universal health coverage, and the PHC approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets.
The PHC approach is defined as a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: (1) primary care and essential public health functions as the core of integrated health services; (2) multisectoral policy and action; and (3) empowered people and communities.
This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV. Specifically, it aims to:
• provide guidance to policy-makers, health system managers and programmatic leads from both PHC and HIV backgrounds regarding opportunities to jointly advance their respective efforts to strengthen PHC and end AIDS as a public health threat; and
• provide a resource for all stakeholders who seek to contribute to strengthening PHC and ending AIDS as a public health threat in a synergistic manner, including people living with HIV, members of key and vulnerable populations, community and civil society representatives, people working in all areas of health systems, researchers, funders and private-sector decision-makers.
more
Health systems context(s) for integrating mental health into primary health care in six Emerald countries: a situation analysis
Mugisha J.; Abdulmalik, J.; Hanlon C; et al.
International Journal of Mental Health Systems; BioMed Central
(2017)
C1
Mugisha et al. Int J Ment Health Syst (2017) 11:7 DOI 10.1186/s13033-016-0114-2
The objective of Critical Considerations and Actions for Achieving Universal Access to Sexual and Reproductive Health in the Context of Universal Health Coverage through a
...
Primary Health Care Approach is to provide guidance to WHO Member States for ensuring progress towards universal access to comprehensive sexual and reproductive health (SRH) in the context of primary health care (PHC)- and universal health coverage (UHC)-related policy and strategy reforms.
more
Core Competencies in Adolescent Health and Development for Primary Care Providers
Pierre André Michaud, Valentina Baltag, Venkatraman Chandra-Mouli et al.
World Health Organization (WHO)
(2015)
Including a Tool to Assess the Adolescent Health and Development Component in Pre-Service Education of Health-Care Providers
This South-East Asia Regional Strategy for Primary Health Care: 2022-2030 aims to accelerate progress in all countries of the Region towards univer
...
sal health coverage (UHC), health security and the health-related Sustainable Development Goals (SDGs). It is intended to provide Member States with guidance on facilitating PHC-orientation through the identification of seven values and 12 strategic actions that collectively embody the philosophy and practice of PHC, enunciated in the 1978 Declaration of Alma-Ata and reaffirmed in the 2018 Declaration of Astana.
more
The toolkit's purpose is to:
improve the primary health care response for older persons.
sensitize and educate
...
primary health care workers about the specific needs of their older clients.
provide primary care health workers with a set of tools/instruments to assess older people's health.
raise awareness among primary care health workers of the accumulation of minor/major disabilities experienced by older people.
provide guidance on how to make primary health care management procedures more responsive to the needs of older people's needs.
offer direction on how to do environmental audits to test primary health care centres for their age-friendliness.
The toolkit comprises a number of instruments (evaluation forms, slides, figures, graphs, diagrams, scale tables, country guidelines, exam sheets, screening tools, cards, checklists, etc.) that can be used by primary health care workers to assess and address older persons' health. These resources are meant to supplement and not to replace local and national materials and guidelines
more
Patient safety standards are critical for the establishment and assessment of patient safety programmes within hospitals. This third edition of the Patient safety assessment manual provides an updated set of standards and assessment criteria that reflect current best practice and WHO guidance. The m
...
anual will support the implementation of patient safety assessments and improvement programmes within hospitals as part of the Patient Safety Friendly Hospital Framework to ensure that patient safety is prioritized and facilities and staff implement best practices. The manual is a key tool for use by professional associations regulatory accrediting or oversight bodies and ministries of health to improve patient safety.
more
As countries aim to progress towards the Sustainable Development Goals (SDGs) and achieving universal health coverage, health inequities driven by racial discrimination and intersecting factors rema
...
in pervasive. Inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities are of concern globally; they are unjust, preventable and remediable.
Health systems themselves are important determinants of health and health equity. They can perpetuate health inequities by reflecting structural racism and discriminatory practices of wider society. For instance, systemic racism, implicit bias, misinformed clinical practice, or discrimination by health professionals contributes to health inequities. However, health systems can also be a leading force for tackling the inequities faced by populations experiencing racial discrimination.
Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
more
Self-care interventions are among the most promising and exciting new approaches to improve health and well-being, both from a health systems persp
...
ective and for people who use these interventions.
The World Health Organization (WHO) uses the following working definition of self-care: Self-care is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker. The scope of self-care as described in this definition includes health promotion; disease prevention and control; self-medication; providing care to dependent persons; seeking hospital/specialist/primary care if necessary; and rehabilitation, including palliative care. It includes a range of self-care modes and approaches. While this is a broad definition that includes many activities, it is important for health policy to recognize the importance of self-care, especially where it intersects with health systems and health professionals.
more
Primary Health-Care Services
recommended
In health emergencies as in periods of stability, restoring access to primary health-care servic
...
es is a priority in so far as many health problems can be dealt with by means of preventive care and
conventional therapy. Depending on the context, the ICRC must often take action in this area, taking into account the level of emergency, the involvement of other actors, the possible evolution of the situation and the organization's operational strategies.
more
