Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. Howe...ver, consolidation of CHVs position within formal health systems has proved to be complex and continues to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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The document is primarily meant to inform mental health and psychosocial support (MHPSS) staff, such as: psychologists, psychosocial counsellors, social workers, psychiatrists, psychiatric nurses, and others who are involved providing individual or ...group counselling, psychotherapy and/or psychiatric treatment for Syrians
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Financing Global Health 2016: Development Assistance, Public and Private Health Spending for the Pursuit of Universal ...hlight medbox">Health Coverage presents a complete analysis of the resources available for health in 184 countries, with a particular focus on development assistance for health (DAH). DAH was estimated to total $37.6 billion in 2016, up 0.1% from 2015. After a decade of rapid growth from 2000 to 2010 (up 11.4% annually), DAH grew at only 1.8% annually between 2010 and 2016. In low-income countries, where much DAH is targeted, DAH made up 34.6% of total health spending in 2016. In upper-middle- and high-income countries, which generally do not receive DAH, DAH accounted for only 0.5% of total health spending. The other 99.5% of health spending – government, prepaid private, and out-of-pocket spending – is the subject of our further analysis.
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DHS Working Papers No. 123
As detailed in MSF’s report Confronting the mental health emergency on Samos and Lesbos, the scale of the needs for mental healthcare and the severity o...f patients’ conditions have overwhelmed the capacity of mental health services on the islands.
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DHS Working Papers No. 93
DHS Working Papers No. 127
INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of...n> the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimate the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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The Lancet Volume 397, ISSUE 10269, P129-170, January 09, 2021
DHS Working Papers No. 106
This document describes the key areas that national governments should consider for the introduction and scale-up of point-of-care (POC) diagnostics within national programmes, as new innovative POC... technologies are being introduced into the market. The next steps taken to include these new innovations within the broader context of national diagnostic networks of conventional laboratories could influence the achievement of the 2030 Fast Track targets for ending the AIDS epidemic.
POC diagnostics, when strategically introduced and integrated into national diagnostic networks, may help catalyse changes that improve the way diagnostics and clinical services are delivered. This document distils this understanding based on programmatic and market experiences of introducing POC diagnostics through catalytic investments in POC HIV technologies across numerous countries in sub-Saharan Africa.
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World Psychiatry. 2010 Jun;9(2):67-77.
The main recommendations are presented in relation to: the need for coordinated policies, plans and programmes, the requirement to scale up services for whole populations, the importance of promoting community... awareness about mental illness to increase levels of help-seeking, the need to establish effective financial and budgetary provisions to directly support services provided in the community. The paper concludes by setting out a series of lessons learned from the accumulated practice of community mental health care to date worldwide, with a particular focus on the social and governmental measures that are required at the national level, the key steps to take in the organization of the local mental health system, lessons learned by professionals and practitioners, and how to most effectively harness the experience of users, families, and other advocates
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Lancet 2022; 399: 1155–200 Published Online March 15, 2022 https://doi.org/10.1016/
S0140-6736(21)02488-0
The world has been turned on its head by the coronavirus disease 2019 (COVID-19) pandemic. This has provided a stark wakeup call on the severe under-financing of health systems around the world. It ...has laid bare the inequalities and limitations in the capacities of countries at all levels of development to prevent major health crises or respond to them. But it doesn’t have to be this way.
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Rueda S, et al. BMJ Open 2016;6:e011453. doi:10.1136/bmjopen-2016-011453
GHWA Task Force on Scaling Up Education and Training for Health Workers