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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
Learn how the decision making process must ensure that appropriate structures and supports are in place to maximize the nursing effort resulting in the best possible care and positive outcomes for the patients/clients, nursing personnel, and the org
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anization.
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 ong
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oing monitoring and evaluation. This manual provides 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.
more
This document aims to support those working in primary care to strengthen IPC, informed by existing WHO IPC guidance and implementation resources. Many of the existing WHO IPC guidance and implementation resources initially developed for acute healt
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h care facilities have a potential utility for IPC in primary care. However, navigating these resources to locate relevant content for IPC in primary care can be challenging as some documents can span over 100 pages. This document extracts relevant content, bringing together existing WHO IPC standards, indicators and implementation approaches that are focused on, or directly relevant to IPC in primary care. It should also be used to identify resources suitable for use in primary care that can be embedded within relevant IPC or other health programmes.
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Infection prevention and control in the context of coronavirus disease (COVID-19): A living guideline
recommended
This second edition of the Infection prevention and control in the context of coronavirus disease (COVID-19): A living guideline provides the most up to date technical guidance on mask use in community settings in the context of COVID-19.
In this edition, new information includes updated mask re
...
commendations for children in community settings including updated age specific recommendations, statements for children with disabilities and those at high risk for complications related to COVID-19 infection. Updated implementation considerations for mask use in school settings are also included.
This living guideline is being published using the MAGICApp online publishing platform https://app.magicapp.org/#/guideline/Lr2a8L , as well as in PDF copy on the WHO website.
more
Cardiovascular disease, diabetes, chronic obstructive pulmonary disease, cancers, and other non-communicable diseases are among the leading causes of morbidity and mortality in low-income, middle-income, and high-income countries, and The Lancet Taskforce recently made the case
...
for investing in non-communicable disease prevention. Now, in The Lancet Planetary Health, Benjamin Bowe and colleagues report that exposure to PM2·5 air pollution is indeed a risk factor for diabetes.
more
The purpose of this book is to provide an overview of Buruli ulcer (Mycobacterium ulcerans infection) for the medical and scientific communities and the general public alike.
Data from 22 countries across the region featured in the study shows children are bearing the heaviest burden of the economic crisis caused by the war in Ukraine. While children make up 25 per cent of the population, they account for nearly 40 per c
...
ent of the additional 10.4 million people experiencing poverty this year.
The Russian Federation has experienced the most significant increase in the number of children living in poverty, with an additional 2.8 million children now living in households below the poverty line, accounting for nearly three-quarters of the total increase across the region. Ukraine is home to half a million additional children living in poverty, the second largest share. It is important to note that this is a conservative estimate which uses a GDP drop of 10 per cent.
more
An interregional meeting on leishmaniasis among neighbouring endemic
countries in the Eastern Mediterranean, African and European regions was organized by the World Health Organization (WHO) Regional Office for the Eastern
Mediterranean in Amman,
...
Jordan, from 23 to 25 September 2018. The meeting was attended by representatives from the health ministries of Albania, Georgia, Greece, Iran (Islamic Republic of), Iraq, Jordan, Lebanon, Morocco, Pakistan, Saudi Arabia, Sudan, Syrian Arab Republic and Tunisia. Representatives from Afghanistan, Algeria and Libya were unable to attend. The Secretariat comprised staff from WHO headquarters, WHO regional offices in the Eastern Mediterranean, Africa and Europe, WHO country offices in Iraq, Pakistan, Syrian Arab Republic and Yemen, and WHO temporary advisors from Spain and Tunisia.
more
Hypertension is the number one health related risk factor in India, with the largest contribution to burden of disease and mortality. It contributes to an estimated 1.6 million deaths, due to ischemic heart disease and stroke, out of a total of about 10 million deaths annually in India. Fifty seven
...
percent of deaths related to stroke and 24% of deaths related to coronary heart disease are related to hypertension. Hypertension is one of the commonest non-communicable diseases in India, with an overall prevalence of 29.8% among the adult population, and a higher prevalence in urban areas (33.8% vs. 27.6%)
according to recent estimates.
Awareness of hypertension in India is low while appropriate treatment and control among those with hypertension is even lower: Hypertension is a chronic, persistent, largely asymptomatic disease. A majority of the patients with hypertension in India are unaware of their condition. This is because of low levels of awareness and the lack of screening for hypertension in adults-either as a systematic programme or as an opportunistic exercise during visits to healthcare providers.
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The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NC
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Ds) into existing health programs for HIV/AIDS, tuberculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
more
Language influences the way we think, how we perceive reality, and how we behave. With respect to HIV, language can embody stigma and discrimination, which impacts access to testing, acquisition of HIV, and engagement with treatment. Language plays a role in supporting respect and empowerment of ind
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ividuals, as communities shape how they are referred to and the labels they wish to use. Consideration and use of appropriate language can strengthen the global response to the HIV pandemic by diminishing stigma and discrimination and increasing support and understanding for individuals and communities living with HIV. Comments and suggestions for modifications should be sent to
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You can download the handbook, worksheets and quick reference cards from the website!
The HHEAT is an ethical analysis tool designed to help humanitarian healthcare workers make ethical decisions. It consists of 3 components: (1) a summary card highlighting key questions, (2) a handbook providing a
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n overview of the tool, and (3) a worksheet for recording the decision-making process. The tool was inspired by research examining ethical challenges and moral distress experienced by humanitarian workers. The HHEAT has been tested and validated by humanitarian workers and experts from the fields of humanitarian medicine and nursing, as well as applied ethics.
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The concept of vulnerability in European asylum procedures
Minos Mouzourakis, Kris Pollet, Ruben Fierens
European Council on Refugees and Exiles (ECRE), Asylum Information Database (AIDA)
(2017)
C2
Once identified as vulnerable, applicants enjoy specific rights and safeguards in the asylum process under EU law. Vulnerability should therefore trigger additional or tailored support to ensure that people have the necessary conditions to bring forward a claim
...
for protection.
more
Emergency response framework, 2nd ed.
recommended
The purpose of this Emergency Response Framework (ERF) is to clarify WHO’s roles and responsibilities in this regard and to provide a common approach for its work in emergencies. Ultimately, the ERF requires WHO to act with urgency and predictabil
...
ity to best serve and be accountable to populations affected by emergencies.
more
It highlights the numerous challenges to quality service provision, along with the organisation’s response to mental health needs, and recommendations for international and regional decision-makers including:
- Advocating and working towards men
...
tal health policies that support adequate funding for mental health care and government suppor
- Legislation to protect the rights of people with mental disorders and vulnerable communities
- Advocating for multi-year funding to support the sustainability of MHPSS programs
- Creating capacity building opportunities consistent with the IASC guidelines and supported with continuous supervision
more
NSW Disaster Mental Health Handbook 4
The Disaster Mental Health Manual and associated handbooks are intended as a resource for mental health staff who are seeking background information and practical guidance and resources to assist in a disaster
...
mental health response.
more
This report presents an assessment of the institutional readiness to detect, prevent and address health issues associated with ASGM and aims to provide an input to the Ministry of Health (MISAU) to define key priorities in the Public Health Strategy on ASGM. Based on the consultation of representati
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ves of MISAU as well as various other ministries and stakeholder groups concerned with ASGM, the report assesses institutional capacity strengths and challenges in the public health sector and identifies key stakeholders relevant for the development and implementation of a public health strategy for the ASGM sector.
more
Key Messages and Recommendations.
The Report, Todos y todas sin excepción, produced by the Global Education Monitoring (GEM) Report and the Regional Bureau for Education in Latin America and the Caribbean (OREALC /UNESCO Santiago), along with the
...
Laboratory of Education, Research and Innovation in Latin America and the Caribbean (SUMMA) shows that, prior to the pandemic, in 21 countries, children from the richest households were five times as likely as the poorest to complete upper secondary school.
Learning outcomes were low before COVID-19. Only half of 15-year-olds achieved minimum proficiency in reading. In Guatemala and Panama, barely 10 disadvantaged 15-year-old students master basic mathematics skills for every 100 of their better-off peers. Indigenous people and Afro-descendants also have lower attainment and literacy rates.
The report includes a set of key recommendations for the next decade, which will help countries achieve the objectives of the 2030 Agenda and calls for schools to be more inclusive, which many still are not.
more
The Director’s guide contains all the information that the course director needs in order to plan and prepare for the course, to decide which modules and sessions will be included in the training, and to select trainers and participants, starting
...
several months before the actual training. It contains lists of the materials and equipment needed, and sample timetables. Copies of the forms to be photocopied and used during the course can be found in the Course handouts. The Director’s guide also describes the director’s role during the course itself.
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