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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 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
Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit
...
h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
more
Almost two years after the signing of the Political Accord for Peace and Reconciliation (APPR), the Central African population is still hostage to an unstable and unpredictable security environment. Continuing conflicts in several areas of the country, structural weaknesses combined with the socio-e
...
conomic effects of the COVID-19 pandemic, and the devastating effects of natural disasters have plunged 2.6 million people into dire needs. Of this total, 1.6 million have severe humanitarian needs, a figure unmatched for five years, reflecting a deterioration in the physical and mental well-being and living conditions of populations across the country.
more
In order to meet changing global population needs and consumer expectations, healthcare systems worldwide are under transformation and face restructuring. As systems adapt and shift their emphasis in response to the disparate requests for healthcare services, oppor-tunities emerge for nurses, especi
...
ally the APN, to meet these demands and unmet needs (Bryant-Lukosius et al. 2017; Carryer et al. 2018; Cassiani & Zug 2014; Cooper & Docherty 2018; Hill et al. 2017; Maier et al.2017). In 2002, the International Council of Nurses (ICN) pro-vided an official position on Advanced Practice Nursing (ICN 2008a). Since that time, worldwide development has increased significantly and simultaneously this field of nursing has matured. ICN felt that a review of its position was needed to assess the relevance of the definition and characteristics offered in 2002. This guid-ance paper defines diverse elements such as assump-tions and core components of the APN. The attributes and descriptors presented in this paper are intended to promote a common vision to continue to enable a greater understanding by the international nursing and healthcare communities for the development of roles commonly identified as Clinical Nurse Specialist (CNS) and Nurse Practitioner (NP).
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Midwifery Capacity Building Strategy for Northern Syria
2017-2021
Available in Arabic
March 2021. “A Decade of Destruction: Attacks on health care in Syria,” highlights with chilling detail how this 10-year war strategy has turned hospitals from safe havens into no-go zones where Syrian civilians now fear for their lives.
The figures and findings reflected in the 2020 PMR represent the independent analysis of the United Nations (UN) and its humanitarian partners based on information available to them. Many of the figures provided throughout the document are estimates based on sometimes incomplete and partial data set
...
s using the methodologies for collection that were available at the time. The Government of Syria has expressed its reservations over the data sources and methodology of assessments used to inform the 2020 Humanitarian Needs Overview (HNO) as well as on a number of HNO findings reflected in the 2020 HRP. This applies throughout the document.
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Evidence from a systematic review on antenatal zinc supplementation was evaluated as part of the World Health Organization (WHO) antenatal care (ANC) guideline development process in 2016, and the following recommendation on zinc supplementation was made: “Zinc supplementation for pregnant women i
...
s only recommended in the context of rigorous research.” The Guideline Development Group (GDG) made this recommendation because it felt that the evidence on the intervention was incomplete and that more research was necessary.
more
The World Health Organization’s comprehensive antenatal care (ANC) guideline WHO recommendations on antenatal care for a positive pregnancy experience was published in 2016 with the objective of improving the quality of routine health care that all women and adolescent girls receive during pregnan
...
cy. The overarching principle – to provide pregnant service users with a positive pregnancy experience – aims to encourage countries to expand their health-care agendas beyond survival, with a view to maximizing health, human rights and the potential of their populations. Recognizing that ANC provides a strategic platform for important health-care functions, including health promotion and disease prevention, 14 out of the 49 recommendations in the WHO 2016 ANC guideline relate to nutrition in pregnancy.
more
The assistive technology capacity assessment (ATA-C) is a system-level tool to evaluate a country’s capacity to finance, regulate, procure and provide assistive technology. It can be used for awareness raising, policy and programme design, and ongoing monitoring and evaluation. This manual provide
...
s guidance and practical information on the ATA-C implementation process. The ATA-C is intended to be implemented by an experienced team, in collaboration with relevant ministries and users’ organizations.
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The case studies in this document are set in different scales and geographies, tackling a wide realm of issues connected to urban housing recovery — locally in Nepal and globally. The case studies are categorized into three:
case studies from partner organizations
case studies from house
...
holds’ perspective
global case studies
more
Over the past two decades, Afghanistan has depended on international donor support to fund essential services like health care. But this donor support has been falling for years and will likely to continue do so—perhaps precipitously—following the announcement by United States President Joe Bide
...
n that the US will withdraw all US forces from Afghanistan by September 11, 2021. This decline in funding has already had a harmful—and life-threatening—impact on the lives of many Afghan women and girls, as it affects access to, and quality of, health care.
more
In the last quarter of 2019 Southern African Regional Interagency Standing Committee Africa (RIASCO) reported that more than 11 million people were experiencing crisis or emergency levels of food insecurity in nine Southern African countries1 due to deepening drought and climate related crisis. The
...
Southern African Development Community (SADC) urged for urgent humanitarian action, and at the beginning of November 2019 Angola, Botswana, Lesotho and Namibia had declared states of drought emergencies, requiring international assistance to address the worsening food insecurity situation.
more
this Service Delivery brief provides evidence-based strategies that can help support drug shops and pharmacies in providing a wider variety of family planning methods and information. Evidence shows that with training and support, pharmacy and drug shop staff can facilitate the use of a broad range
...
of modern contraception, especially in areas where the unmet need is high, access to family planning services is poor, and health worker shortages and other barriers prevent women, men, and youth from accessing family planning services
Availabe in English, French, Spanish and Portuguese
more
The internationally recognized criteria for diagnosis of neurocysticercosis include a requirement for neuroimaging techniques, such as computerized tomography (CT) and/or magnetic resonance imaging (MRI), ideally supported by serology. These facilities are not available in all settings, especially i
...
n rural areas of low-income countries, making it difficult to identify and treat patients. Additionally, there is controversy about the role, type and duration of anthelmintic, antiinflammatory and antiepileptic drug (AED) treatments for different forms of neurocysticercosis.
These guidelines were developed to assist health-care providers in appropriate, evidence-based management of parenchymal neurocysticercosis. The guidelines do not address other forms of neurocysticercosis and do not include management of extraparenchymal disease (including cysticerci in the cerebral ventricles or subarachnoid space). The aim of the guidance is to improve decision-making to ensure appropriate patient care and to avoid misdiagnoses and inappropriate treatment of patients with neurocysticercosis.
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