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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 systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar
...
y 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
ndependent of the current conflict, the health sector in Ukraine faces several critical shortcomings. In particular, the country has an oversupply of hospitals and an undersupply of primary care and diagnostic facilities. Addressing these limitations will require substantial amounts of capital inves
...
tment, but constraints on public finances in the post-war context will reduce the Government’s ability to fund the needed reconfiguration. Multiple international financial institutions have stated their intention to support reconstruction in the aftermath of the war. The use of public–private partnerships (PPPs) may support the achievement of these outcomes and their use in Ukraine is likely to remain an important issue for Government policy-makers and their partners to consider in a variety of post-war scenarios.
more
The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in
...
health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
more
The 2021 Report examines country health spending patterns and trends over the past 20 years, before the COVID-19 pandemic, with greater focus on public spending on health. The report also presents spending on primary health care, preliminary health expenditure in 2020 for a small set of countries (i
...
ncluding their health spending on COVID-19) and an analysis of high-income countries spending patterns, in particular during the global financial crisis. The report also points out the need for more public investment in health to get progress towards UHC back on track and strong health security.
more
Since the discovery of insulin nearly 100 years ago, advances in diabetes treatments and therapies have transformed the lives of people
with diabetes (PwD), notably reducing the daily burden of its management.
Newer technologies, including those driven by artificial intelligence, have the potentia
...
l to further improve the quality of life of PwD and help
identify and diagnose people at risk of developing Type 2 diabetes and diabetes-related complications early. However, medical and technological advances alone are not enough to fix the diabetes challenge. It is also critical to acknowledge the complexity and the seriousness of diabetes, its impact on the quality of life and well-being of over 32 million PwD in the EU and the financial burden it represents for health systems and society at large.
more
The Health Sector Policy gives general orientations for the sector which are further developed in the various sub-sector policies guiding key health programs and departments. All health sub-sector policies will be updated in line with this new policy. The Health Sector Policy is the basis of nationa
...
l health planning and the first point of reference for all actors working in the health sector. The overall aim of this policy is to ensure universal accessibility (in geographical and financial terms) of equitable and affordable quality health services (preventative, curative, rehabilitative and promotional services) for all Rwandans. It sets the health sector’s objectives, identifies the priority health interventions for meeting these objectives, outlines the role of each level in the health system, and provides guidelines for improved planning and evaluation of activities in the health sector. A companion Health Sector Strategic Plan (HSSP) elaborates the strategic directions defined in the Health Sector Policy in order to support and achieve the implementation of the policy, and more detailed annual operational plans describe the activities under each strategy.
more
In March 2020 the IASC Reference Group on Mental Health and Psychosocial Support uniting 57 humanitarian organizations as member issued the Interim Briefing Note Addressing Mental Health and Psychosocial Aspects of COVID-19 Outbreak. This document has proven to be very useful in the response and has
...
till now been translated in 24 languages. It covers a set of recommended activities as well as messages for different target groups.
The current document is an annex to the Interim Briefing Note and is meant to support the MHPSS operational response within the various sectors of humanitarian work. Approaches and interventions to MHPSS are not confined to one sector, but need to be integrated within many existing sectors and clusters.This document contains a wealth of operational information and practical approaches that can be used for humanitarian programming in health, SGBV, community-based protection, nutrition, camp management and camp coordination.
more
In an effort to improve the capabilities and accountability of humanitarian and economic practitioners, the SEEP (Small Enterprise Education and Promotion) Network's Minimum Economic Recovery Standards focus on minimum industry standards for facilitating economic recovery in crisis situations.
Th
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e handbook sets out strategies and interventions designed to improve income, cash flow, asset management, and growth among crisis-affected households and enterprises. These include financial services, productive assets, employment, and enterprise development. It emphasizes encouraging the re-start of enterprises and livelihoods strategies, and improving market productivity and governance
more
These draft guidelines are designed to encourage humanitarian and development non-governmental organisation (NGO) practitioners to think about the types of scientific information and expertise they may need, how to access and use them, and how to ensure that they are applied in an ethical and accoun
...
table manner. The publication addresses the need to defines the problem and the purpose of integrating science with the users of science, issues around access to science and understanding scientific information, how to apply the science and the important of monitoring and evaluation of impact. Case studies include a project from Christian Aid and the Evangelical Association of Malawi which brought together community members from Village Civil Protection Committees with scientists from the Department of Climate Change and Meteorology and District Council staff responsible for water management and disaster risk reduction in order to tackle a problem of flooding
more
Care and Support Centre (CSC) is a national initiative to provide expanded and holistic care and support services for PLHIV. The guideline focuses on the objectives, criteria for selection, required infrastructure, human resources, MIS tools, and financial
...
guidelines for CSCs. This guideline will be useful to the care providers, programme managers, and all stakeholders in providing excellent care to the people living with HIV/AIDS
more
This study, and similar studies in Kenya, Mozambique, Swaziland, Uganda, and Zambia is the outcome of close collaborative by a team in Swaziland, with technical and financial support from the UNAIDS Regional Support Team for Eastern and Southern Afr
...
ica, UNAIDS Geneva, and the World Bank's Global HIV/AIDS Program (Global AIDS Monitoring and Evaluation Team). The study entailed using existing data and collecting new data to better know the country's HIV epidemic, know the country HIV response and how funding was allocated, so as to improve the HIV response and strengthen prevention based on evidence on what works to prevent new infections.
more
VADEMECUM | This Vademecum is intended to provide a benchmark for aid workers—whether working in the field or at a strategic level—in particular concerning the formulation and implementation of programmes of prevention or response to humanitarian crises. It is not solely a theoretical document b
...
ecause, in addition to guiding principles, it also provides concrete examples of how to ensure protection of the rights of people with disabilities, including in terms of humanitarian aid. This Vademecum has been drafted in adherence to the UN Convention on the Rights of Persons with Disabilities, which has been in force since 2006 and which reaffirms the importance of protecting the safety of people with disabilities in dangerous situations.
more
UNICEF Child Alert | February 2018
Back in Myanmar, an estimated half million Rohingya remain largely sealed off in their communities and displacement camps, fearful that the violence and horror that had driven so many of their relatives and neighbours to fl ee would engulf them too. Today, t ... here are an estimated 720,000 Rohingya children in southern Bangladesh and Myanmar’s Rakhine State, in dire need of humanitarian assistance and protection – and looking to the outside world for help. more
Back in Myanmar, an estimated half million Rohingya remain largely sealed off in their communities and displacement camps, fearful that the violence and horror that had driven so many of their relatives and neighbours to fl ee would engulf them too. Today, t ... here are an estimated 720,000 Rohingya children in southern Bangladesh and Myanmar’s Rakhine State, in dire need of humanitarian assistance and protection – and looking to the outside world for help. more
UN, international agencies and experts released a groundbreaking report demanding immediate, coordinated and ambitious action to avert a potentially disastrous drug-resistance crisis.
If no action is taken - warns the UN Ad hoc Interagency Coordinating Group on Antimicrobial Resistance who release
...
d the report – drug-resistant diseases could cause 10 million deaths each year by 2050 and damage to the economy as catastrophic as the 2008-2009 global financial crisis. By 2030, antimicrobial resistance could force up to 24 million people into extreme poverty.
more
It is the policy of the GoR to ensure that children’s rights are met through the provision of basic needs and services for all children in the country, and protect them from abuse and exploitation. Children are defined as persons below the age of 18 years and the ICRP covers children from the time
...
before their birth until they complete the age of 18 years. The Integrated Child Rights Policy of Rwanda is based on seven key themes: Identity and Nationality; Family and Alternative Care; Survival, Health and Standards of Living; Education; Protection; Justice; and Child Participation.
more
A publication about girls escaping natural disasters and violent conflict in Eastern Africa
Children are on the move. In East Africa region, it is estimated that over 5 million children have migrated across borders or been forcibly displaced in their own country.
Forcable displacement is p ... ushing more and more children out of their homes and communities, escaping the violence of war and conflict, only to fall vulnerable to other forms of violence. Girls are particularly vulnerable and need extra protection.
Every day, girls on the move in East Africa face a variety of rights violations, including:
• Exploitation and violence
• Being separated from their families
• Deprivation of essential services
• Use and recruitment by armed groups
• Sexual abuse
• Child marriage
This report highlights concerns that girls in eastern Africa face and calls on international and national decision makers to prevent and end violence that children face when they are forced to flee their homes. more
Children are on the move. In East Africa region, it is estimated that over 5 million children have migrated across borders or been forcibly displaced in their own country.
Forcable displacement is p ... ushing more and more children out of their homes and communities, escaping the violence of war and conflict, only to fall vulnerable to other forms of violence. Girls are particularly vulnerable and need extra protection.
Every day, girls on the move in East Africa face a variety of rights violations, including:
• Exploitation and violence
• Being separated from their families
• Deprivation of essential services
• Use and recruitment by armed groups
• Sexual abuse
• Child marriage
This report highlights concerns that girls in eastern Africa face and calls on international and national decision makers to prevent and end violence that children face when they are forced to flee their homes. more
The purpose of the PAS III is to guide Pakistan’s overall national response for HIV and AIDS through 2020, through focused interventions with set targets, costs, roles and responsibilities. The successful implementation of PAS III involves multiple stakeholders to achieve priority outcomes outline
...
d in the Strategy. The Strategy focuses on allocating limited resources to scale up high-impact, high-value interventions such as HTC and treatment to reduce AIDS related deaths and new HIV infections. Priorities in the PAS III have been identified to ensure maximum impact in reducing new infections, especially among key populations, improving treatment uptake and retention, and improving the quality of life of people living with HIV and AIDS in the context of limited financial and human resources.
more
The Republic of the Union of Myanmar is at a historic moment, with a new civilian government assuming power in 2016. The country graduated to lower-middle-income status in 2015, and has made significant progress in reducing poverty, improving food security and addressing malnutrition.
The remai ... ning challenges to food and nutrition security and achievement of Sustainable Development Goal 2 targets include continued population displacements resulting from conflict, vulnerability to extreme weather events, poverty, limited social protection coverage, high malnutrition and persistent gender inequalities. more
The remai ... ning challenges to food and nutrition security and achievement of Sustainable Development Goal 2 targets include continued population displacements resulting from conflict, vulnerability to extreme weather events, poverty, limited social protection coverage, high malnutrition and persistent gender inequalities. more
Flood Disaster Risk Management - Hydrological Forecasts: Requirements and Best Practices (Training Module)
Vogelbacher, A.
National Institute of Disaster Management (NIDM), Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ)
(2013)
C1
This Case Study explores flood forecasting systems from the perspective of its position within the flood warning process. A method for classifying the different approaches taken in flood forecasting is introduced before the elements of a present-day flood forecasting system are discussed in detail.
...
Finally, the state of the art in developing flood forecasting systems is addressed including how to deal with specific challenges posed.
The target group of this case study are decision makers in disaster risk management and/or water management. The case study should help to understand some hydrologic basics of the flood forecast and assist in the administration and implementation of an appropriate flood warning system in a specific environment, to find the best solution for a region.
Best solutions depend mainly on quality and availability of data, the areas and/or points of interest, catchment properties, cross border catchments, and financial capabilities with special consideration of flood forecast. more
The target group of this case study are decision makers in disaster risk management and/or water management. The case study should help to understand some hydrologic basics of the flood forecast and assist in the administration and implementation of an appropriate flood warning system in a specific environment, to find the best solution for a region.
Best solutions depend mainly on quality and availability of data, the areas and/or points of interest, catchment properties, cross border catchments, and financial capabilities with special consideration of flood forecast. more
Recently, Sri Lanka has been impacted by multiple natural disasters. Sri Lanka experienced a landslide in October 2014, and flooding in December 2014.8 Sri Lanka withstood the worst drought conditions witnessed in four decades in 2016; the extreme drought conditions extended into 2017 and produced s
...
ubstantial economic and social effects. The drought was responsible for an increase in national poverty levels, due to reduced cultivation income, especially for rural farmers. ... In May 2017, Sri Lanka experienced continuous rains causing flash floods and extreme devastation. However, despite natural disasters and challenges posed by a complex political environment, Sri Lanka’s financial performance remained largely satisfactory in the first half of 2017.
more
