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2
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 coverage (UHC). However, primary health-care syst
...
ems 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
Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them as effec
...
tive as possible. With this in mind, this manual is intended to be used a practical guide for policymakers and program
managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale. Throughout, we discuss major policy and programmatic issues that decision-makers and planners need to consider when designing, implementing, scaling up or strengthening a national-level CHW program. We offer an overview
of specific challenges CHW programs face, country lessons, tools, and other resources that may be helpful, while incorporating relevant programmatic examples as much as possible.
more
This policy brief aims to provide a review of the current progress on implementing the Burkina Faso national action plan on AMR, identifies critical gaps, and highlights findings to accelerate further progress in the human health sector. The target
...
audience includes all those concerned with implementing actions to combat antimicrobial resistance in Burkina Faso.
more
The Government of Kenya, through the Ministry of Health, has the
constitutional obligation to provide the highest level of health care for its
citizens. The Ministry of
...
Health’s review of the 2015 Policy document
on infection prevention and control (IPC) is in line with that goal.
more
A sourcebook
Clean and sustainable household energy and appliances, for cooking, heating and lighting can improve health, increase productivity, reduce poverty and protect the environment while addressing air pollution.
In 2013 the World Health Organization (WHO) published the report Protecting health from climate change:vulnerability and adaptation assessment. The aim was to provide basic and flexible guidance on
...
conducting national or subnational assessments of current and future vulnerability (the susceptibility of a population or region to harm) to the health risks of climate change, and of policies and programmes that could increase resilience, taking into account the multiple determinants of climate-sensitive health outcomes.
That guidance has been a very useful tool, applied to more than 50 countries and settings, and has helped countries to prepare their health contributions to United Nations Framework Convention on Climate Change national adaptation plans.
Since the launch of the guidance, WHO, technical partners such as Health Canada, and countries have learned much in terms of its applicability in different countries, at national and local levels.
At the same time, knowledge on climate change and health has increased.
WHO, the Pan American Health Organization and Health Canada have produced this updated version, which aims to better support countries in their assessments by proposing a simpler tool that incorporates
all lessons learned.
more
This European compendium was produced to provide operational examples of the new nursing and midwifery roles and new service delivery models currently being employed across the Region. The case studies directly relate to the priority areas in Health
...
2020 and exemplify the types of activities needed to fully implement the objectives within the Strategic Directions framework.
more
Self-care interventions are among the most promising and exciting new approaches to improve health and well-being, both from a health systems perspective 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
The QualityRights training and orientation modules have been developed to enhance the knowledge, skills and understanding of key stakeholders on how to promote the rights of people with psychosocial, intellectual or cognitive disabilities, improve the quality of services and support provided in the
...
field of mental health and related areas, in line with international human rights standards, in particular the UN Convention on the Rights of Persons with Disabilities and the recovery approach.
mental health and related fields, in accordance with international human rights standards, in particular the UN Convention on the Rights of Persons with Disabilities and the recovery approach.
more
Les modules de formation et d’orientation QualityRights ont été élaborés pour renforcer les connaissances, les compétences et la compréhension des principales parties prenantes sur la manière de promouvoir les droits des personnes en situation de handicap psychosocial, intellectuel ou cogni
...
tif, d'améliorer la qualité des services et des aides fournis dans le domaine de la santé mentale et dans les domaines connexes, conformément aux normes internationales en matière de droits humains, et en particulier la Convention des Nations unies relative aux droits des personnes handicapées et l'approche du rétablissement.
more
This document provides an overview of strategic purchasing of nutrition services within primary health care. It introduces key terms and payment methods for countries to use in preparing to transform their
...
health financial systems to scale up nutrition services. It does so by introducing nutritional perspectives to strategic health purchasing core areas: What to buy, From whom to buy and How to buy.
more
This publication is a compendium of 49 country examples highlighting efforts in improving refugees’ and migrants’ health following the adoption of the WHO Global Action Plan on Promoting the health
...
of refugees and migrants at the seventy-second World Health Assembly, in May 2019.
more
The overall objective of the framework is to support WHO and Members States in meaningful engagement of people living with NCDs, and mental health and neurological conditions to co-create and enhance related policies, programmes and services. This f
...
ramework will contribute to advancing understanding, knowledge and action on meaningful engagement and related participatory approaches from an evolving evidence base. It provides practical guidance and actions for transitioning from intention to action to operationalize meaningful engagement.
The aim of the framework is to guide people working at WHO and in Member States in ensuring meaningful engagement with individuals with lived experience. WHO will advocate for, provide technical assistance and operationalize implementation at its three levels (headquarters, regional and country offices) and will support Member States in implementation at national level through established processes and procedures.
more
The Quadripartite organizations have developed the One Health Priority Research Agenda for AMR report, this is a joint initiative to assist in directing and catalysing scientific interest and financial investments for the priority research agenda ac
...
ross sectors for countries and funding bodies. The research agenda also serves as a guide to mitigate One Health AMR that will help policymakers, researchers, and a multidisciplinary scientific community work together on solutions to prevent and mitigate AMR within the One Health approach.
more
Member States of the Region have initiated processes to strengthen leadership and governance for mental health. Several countries have developed and implemented mental health plans, strategies and l
...
egislations. Direct spending on mental health needs to be increased throughout the Region through the health sector as well as other relevant sectors.
more
A practical handbook. This Health Cluster Guide (2nd edition, 2020) provides practical advice on how WHO, Health Cluster Coordinators and partners can work together during a humanitarian crisis to a
...
chieve the aims of reducing avoidable mortality, morbidity and disability, and restoring the delivery of and equitable access to preventive and curative health care.
It highlights key principles of humanitarian health action and how coordination and joint efforts among health and other sector actors can increase the effectiveness and efficiency of health interventions and promote better health outcomes. It draws on Inter-Agency Standing Committee and other expert guidance and includes lessons from field experience in acute and protracted crises.
The coordination principles and practice presented in Health Cluster Guide are equally valid for coordinators and members of health sector groups that seek to achieve effective health action in countries where the cluster approach has not been formally adopted.
more
The Interagency Emergency Health Kit 2017
recommended
Interagency Guidelines; Medicines and medical devices for 10 000 people for approximately three month.
