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Toolboxes
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Germanys expanding role in global health
Ilona Kickbusch, Christian Franz, Anna Holzscheiter, Iris Hunger, Albrecht Jahn, Carsten Kö; hler, Oliver Razum, Jean-Olivier Schmidt
Lancet 2017; 390: 898– 912
(2017)
CC
Germany has become a visible actor in global health in the past 10 years. In this Series paper, we describe how this development complements a broad change in perspective in German foreign policy.
Hidden cities: unmasking and overcoming health inequities in urban settings
WHO, UN-HABITAT
(2010)
C_WHO
The World Health Organization (WHO) and United NationsHuman Settlements Programme (UN-HABITAT) joint globalreport, Hidden cities: unmasking and overcoming healthinequities in urban settings, exposes the extent to whichcertain city dwellers suffer di
...
sproportionately from a wide range of diseases and health problems. This report provides information and tools to helpgovernments and local leaders reduce health inequities in their cities. The objective of the report is not tocompare rural and urban health inequities. Urban healthinequities need to be addressed specifically for they aredifferent in their magnitude and in their distribution.
more
The Urban Health Equity Assessment and Response Tool (Urban HEART) is a user-friendly guide for policy- and decision-makers at national and local levels to: identify and analyse inequities in health
...
between people living in various parts of cities, or belonging to different socioeconomic groups within and across cities; facilitate decisions on viable and effective strategies, interventions and actions that should be used to reduce inter- and intra-city health inequities.
Also available in French and Spanish: https://apps.who.int/iris/handle/10665/79060
more
Countries must invest at least 1% more of GDP on primary health care to eliminate glaring coverage gaps
At current rates of progress up to 5 billion people will miss out on health care in 2030
C
...
ountries must increase spending on primary healthcare by at least 1% of their gross domestic product (GDP) if the world is to close glaring coverage gaps and meet health targets agreed in 2015, says this new report. They must also intensify efforts to expand services countrywide.
The world will need to double health coverage between now and 2030, according to the Universal Health Coverage Monitoring Report. It warns that if current trends continue, up to 5 billion people will still be unable to access health care in 2030 – the deadline world leaders have set for achieving universal health coverage. Most of those people are poor and already disadvantaged.
more
This report considers how to integrate health into urban planning, investments, and policy decisions, so as to support the implementation and achievement of the goals and objectives of the New Urban Agenda.
eLearning for undergraduate health professional education
Al-Shorbaji, Najeeb, Atun, Rifat, Car, Josip, Majeed, Azeem, Wheeler, Erica.
World Health Organization, Imperial College London
(2019)
C1
A systematic review informing a radical transformation of health workforce development
Optimization of ART in Ukraine: general principles of ART optimization from a public health perspective
Professor J. Lundgren
World Health Organization (Europe); Centre for Health & Infectious Disease Research
(2016)
C_WHO
Mission report April 2016
This Community Health Systems (CHS) Catalog country profile is the 2016 update of a landscape
assessment that was originally conducted by the Advancing Partners & Communities (APC) project
in 2014. The CHS Catalog focuses on 25 countries deemed pr
...
iority by the United States Agency for
International Development’s (USAID) Office of Population and Reproductive Health, and includes
specific attention to family planning (FP), a core focus of the APC project.
The update comes as many countries are investing in efforts to support the Sustainable Development
Goals and to achieve universal health coverage while modifying policies and strategies to better align
and scale up their community health systems.
The purpose of the CHS Catalog is to provide the most up-to-date information available on community
health systems based on existing policies and related documentation in the 25 countries. Hence, it does
not necessarily capture the realities of policy implementation or service delivery on the ground. APC
has made efforts to standardize the information across country profiles, however, content between
countries may vary due to the availability and quality of the data obtained from policy documents.
more
In 1989, the Republic of Benin was facing a great social and
economical crisis. Civil servants of all the sectors in public
administration were on strike. People did not know where to
go for their health care. Salaries were not paid for more than
...
six months and life for the general population was very dificult.
The country was about to degenerate into civil war as a
result of the civil unrest in the country.
Thanks to the assistance from the French, and Canadian
and American Mennonite missionaries, the Bethesda Health
Centre was started in 1990 with US$ 1,000 granted by theses
partners. Today, the Health Centre of Bethesda has expanded
and has become a large Hospital in Cotonou. It hosts each
year about 100,000 patients and has developed the department
of paediatrics, ophthalmology, stomatology, cardiology,
obstetrical gynaecology, X-rays, etc. The Hospital has also
put in place an AIDS service which has been promoted by the
government to the status of an AIDS Treatment Centre.
In an integrated vision, Bethesda has established other departments.
In 1993, the Sanitation department was established
to implement sanitation and environmentally-friendly
projects aimed at reducing the high incidence of some diseases
frequently treated at the hospital. In 1996, the decision
was made to establish a micro-inance department called
PEBCo. This initiative, which currently has 10,000 clients,
uses community savings to promote income-generating activities.
Since many women were obliged to use the loans for
family needs (health care, children schooling, etc.), they were
unable to reimburse them as planned. Hence the Bethesda
non-government organization (NGO) recently began an initiative
to provide a community-based health insurance option
for the population in 2006. There are now 12,000 members.
This paper focuses on the presentation of Benin and the program,
but also describes how the project could be better improved
and what were its beneits and impacts.
Field Actions Science Reports
The journal of field actions
Vol. 4 | 2010
Vol. 4
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
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In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles
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terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of
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CVD diseases. Affordable essential medicines and technologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
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Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary care systems can include team-based care strategies in their clinic workflows and protocol
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s. Team-based care uses multidisciplinary teams (which may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
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Monitoring is a crucial element in any successful programme. It is important to
know if health care facilities – and ultimately countries – are meeting the agreed
goals and objectives for preventing and managing cardiovascular diseases (CVD).
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Monitoring is the on-going collection, management and use of information to
assess whether an activity or programme is proceeding according to plan and/
or achieving defined targets. Not all outcomes of interest can be monitored. Clear
outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met.
To allow progress to be monitored, this module provides a set of indicators on
CVD management. Agreeing on a set of indicators allows countries to compare
progress in CVD management and treatment across different districts or
subnational jurisdictions, as well as at a facility level, identify where performance
can be improved, and track trends in implementation over time. Monitoring
these indicators also helps identify problems that may be encountered so that
implementation efforts can be redirected.
This module starts from the collection of data at facility level, which is then
“transferred up” the system: facility-level data are aggregated at subnational level
to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys.
Implementing a monitoring system requires action at many levels. At national and
subnational levels, staff can determine how best to integrate data elements into
existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS).
In the facility setting, personnel must be aware of what data are needed. Sample
data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools
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HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance implementation of WHO PEN by providing:
• operational guidance on further integrating CVD management
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• technical guidance on evaluating the impact of CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
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