22nd edition
The purpose of the SAHR has always been to analyse and assess progress and challenges in key areas of the health system, and to propose recommendations for improvement. We are pleased to continue this tradition in the 2019 edition, which presents a unique collection of perspectives on ...the key challenges in implementing universal health coverage (UHC) in South Africa, as analysed by experts in various fields.
Each of the 20 chapters deals with aspects of the UHC journey, dedicated towards an equitable and inclusive national health system that leaves no-one behind. While some authors describe the fundamental changes and practical considerations required to reconfigure the country's health system, others have reflected on specific programmatic areas and have made recommendations from a National Health Insurance (NHI)/UHC lens.
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Dziva Chikwari et al. Implementation Science (2018) 13:70 https://doi.org/10.1186/s13012-018-0762-5
The United States Agency for International Development (USAID) Bureau for Democracy, Conflict, and Humanitarian Assistance Office of U.S. Foreign Disaster Assistance (DCHA/OFDA) requested Food and Nutrition Technical Assistance II Project (FANTA-2) assistance to review Community-Based Management of ...Acute Malnutrition (CMAM) in four West African countries—Burkina Faso, Mali, Mauritania, and Niger—to help identify DCHA/OFDA 2010 and 2011 program priorities, including where DCHA/OFDA investment should be directed to support CMAM. The goal was to review CMAM program implementation and its integration into national health systems to provide DCHA/OFDA a status report for each country; draw lessons learned; and make recommendations on challenges, promising practices, gaps, and priority areas for DCHA/OFDA support during 2010 and 2011. The review was intended for DCHA/OFDA program planning purposes and also potentially as an advocacy tool to guide other donors in planning CMAM support in the region. After all four countries have been reviewed, FANTA-2 will develop a synthesis report. The current document presents a summary report on CMAM in Burkina Faso only.
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The COVID-19 pandemic has affected everyone, including key populations at higher risk of HIV. And the gains made against other infectious diseases, including HIV, are at risk of being reversed as a result of disruptions caused by COVID-19. This is the background to a new report published by FHI 360,... in collaboration with UNAIDS, which gives advice on how to minimize the impacts of COVID-19 on key populations.
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2020 is a critical year for our Joint Programme as we collectively define the path to getting back on track to ending the AIDS epidemic by 2030. Our revised timelines for adoption of the next strategy are highly ambitious. We need the full support of all the tremendously dedicated people in UNAIDS-w...ithin our staff, our board and all our stakeholders to make this happen.
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State of Health in the EU Cycle.
With the coronavirus (COVID-19) once again spreading rapidly, and the re-introduction of containment measures to flatten the curve of the epidemic, it is crucial for policymakers to plan effective strategies to re-open their economies to avoid further re-confinement...s. This should include much more effective testing, tracing and isolation policies that people can easily follow, as well as improved social distancing measures
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MOH clinical practice guidelines
Suicide is a serious public health problem surrounded by stigma, myths, and taboos. With an annual average of 81,746 suicide deaths in the period 2010–2014 and an age-adjusted suicide rate of 9.3 per 100,000 population (age-unadjusted rate of 9.6), suicide continues to be a public health problem o...f great relevance in the Region of the Americas. Contrary to common belief, suicides are preventable with timely, evidence-based, and often low-cost interventions. It is estimated that for each suicide that occurs, there are more than 20 attempts. Suicide can occur at any age and it is the third highest cause of death among young people between the ages of 20 and 24 in the Region of the Americas.
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The document is structured into five sections. The first presents the key experiences and challenges that justify a renewal of the EPHFs. The second section updates the groundwork for the exercise of public health and provides a framework to inform the exercise of the new essential functions. The th...ird section proposes a new integrated approach for implementing the EPHFs. The fourth section presents a new list of 11 EPHFs related to each stage of this integrated approach. Finally, in the last section, considerations are put forth to guide EPHF implementation as a means of strengthening the health sector.
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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.
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Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.... These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
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The Community Health Systems (CHS) Catalog is a resource that provides information on community health program workers, and interventions for the 25 countries deemed priority by USAID’s Of of Population and Reproductive Health. It comprises a compilation of 25 country profiles developed from a de...sk review of community health policies, strategies, a related documentation.
This document summarizes country trends drawn from the CHS Catalog and highlights interesting and relevant findings
about the global community health policy landscape.
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Post Graduate programme is essential to prepare nurses to improve the
quality of nursing education and practice in India. .
Post graduate programme in nursing builds upon and extends competence
acquired at the graduate levels, emphasizes application of relevant theories
into nursing practice, ed...ucation, administration and development of
research skills.
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Low- and middle-income countries (LMICs) experience a high disease burden for epilepsy, a chronic neurological condition.The authors evaluate the cost-effectiveness of community health workers (CHWs) to improve adherence to medication for epilepsy in South Africa. They found that utilizing CHWs to i...mprove medication adherence was cost-effective.
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