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Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and
...
health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and technologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
more
Medical care for people caught up in armed conflict and other insecure environments saves lives and alleviates suffering. It is one of the most immediate and high priority needs of an affected population and is often the first type of response activ
...
ated and/or requested by authorities and affected communities. Medical teams working in armed conflict and other insecure environments
frequently face serious threats to their security and safety, challenges to patient access, and at times limited acceptance by affected communities in which they work and parties to the conflict. Such difficulties are likely to increase (6) and
thereby creating a critical need to establish contact and trust with all sides in conflicts and in other insecure environments to ensure operational continuity. This trust can best be achieved when all sides perceive the medical teams to be neutral, impartial, and independent, and specifically not aiding (or being perceived to aid) any one party to achieve a military, political or economic
advantage. For medical teams that are deploying increasingly closer to the frontlines, the implications of and consequences for both staff and patients of teams not being fully prepared, and/or not fully comprehending the context in which they work, can be severe. Medical response can easily be hindered or compromised by intentional or unintentional acts and the behaviour and
conduct of the teams themselves
more
WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being prevent
...
able and treatable, PPH results in around 70 000 deaths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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The purpose of the landscape analysis is ultimately to facilitate improved engagement of private providers, thereby contributing to universal access
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to quality and affordable TB care and the end of the TB epidemic. It focuses on the role of private for-profit providers and on specific challenges and experiences in engaging them for TB prevention and care.
more
A Review of Community Health Worker (CHW) knowledge, attitudes and practices relating to the sexual health of MSM, including existing training materials and manuals in Europe & neighbouring countries
C. Folch; P. Fernández-Dávila; J. Palacio-Vieira; et al.
European Commission; Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT); European AIDS Treatment Group
(2020)
C2
Accessed: 07.03.2020
A Review of Community Health Worker (CHW) knowledge, attitudes and practices relating to the sexual health of MSM, includi
...
ng existing training materials and manuals in Europe and neighbouring countries (D5.1)
Contract 2015 71 01 A behavioural survey for HIV/AIDS and associated infections and a survey and tailored training for community based health workers to facilitate access and improve the quality of prevention, diagnosis of HIV/AIDS, STI and viral hepatitis and health care services for men who have sex with men (MSM).
Pubic Health
more
Toolkit
HIV Treatment and Care
This field study to measure access to and use of medicines was undertaken in GHANA in May-June 2008. The study assessed informati
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on on the socio-economic level of households, and access to and use of medicines for acute and chronic conditions as well as opinions and perceptions about medicines. The survey was conducted in six regions. In each region, six reference public heath care facilities were selected among those participating in the Level II Facility Survey that was carried out in parallel. Within defined distances from each reference public health care facility, households were selected by purposive cluster sampling. A total of 1065 household respondents were interviewed by means of a structured paper questionnaire
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Community health worker teams are potential game-changers in ensuring access to care in vulnerab
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le communities. Who are they? What do they actually do? Can they help South Africa realize universal health coverage? As the proactive arm of the health services, community health workers teams provide household and community education, early screening, tracing and referrals for a range of health and social services. There is little local or global evidence on the household services provided by such teams, beyond specific disease-oriented activities such as for HIV and TB. This paper seeks to address this gap.
more
STGs are designed to assist health care professionals in making decisions about appropriate, effective patient
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care. However, health managers often have trouble setting and meeting the high standards required of modern, developed health care systems. With stakeholders expressing concern over issues such as strength of evidence, transparency, conflicts of interest, and effective implementation, it is clear that many health care professionals need further guidance in developing and making use of STGs.
This manual guides health professionals through the process of establishing and implementing STGs, placing special emphasis on the low- and middle-income country (LMIC) context. By including tools, templates, and success stories as well as hyperlinks to useful resources, the manual helps health practitioners understand not only important concepts of treatment guidelines, but also how they can best be used in practice.
more
Bull World Health Organ 2020;98:773–780
Universal health coverage (UHC) depends on a strong primary health-
...
care
system. To be successful, primary health care must be expanded at community and household levels as much of the world’s population still lacks access to health facilities for basic services. Abundant evidence shows that community-based interventions are effective for improving health-care utilization and outcomes when integrated with facility-based services. Community involvement is the cornerstone of local, equitable and integrated primary health care.
more
In 2017, 3.6 million of the estimated 10 million people with TB worldwide were “missed” by national TB programmes (NTPs). Two thirds of them are thought to access TB treatment of questionable qu
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ality from public and private providers who are not engaged by the NTP. The quality of care provided in these settings is often not known or substandard. Closing these gaps and ensuring patient-centred care imply that quality-assured and affordable TB services must be made available wherever people choose to seek care.
more
Quality of care in fragile, conflict-affected and vulnerable settings: tools and resources compendium
recommended
This compendium represents a curated, pragmatic and non-prescriptive collection of tools and resources to support the implementation of interventions to improve quality of
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care in such contexts. Relevant tools and resources are listed under five areas: Ensuring access and basic infrastructure for quality; shaping the system environment; reducing harm; improving clinical care; and engaging and empowering patients, families and communities.
more
Getting Contraceptives To Health Facilities: 10 Questions For Community-Based Groups To Consider
recommended
This Guide helps all the health care providers in the non- public sector to explore alternative means of
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access to contraceptives and skills to determine quantities required and management of stock. Health care providers include community health workers, nurses and midwives, clinical officers and medical doctors.
more
This is an open-access training course for frontline healthcare providers who manage acute illness and injury with limited resources. Produced in response to requests from multiple countries and int
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ernational partners, the BEC package includes a Participant Workbook and electronic slide decks for each module. Integrating the guidance from WHO Emergency Triage, Assessment and Treatment (ETAT) for children and the Integrated Management of Adult/Adolescent Illness (IMAI), BEC teaches a systematic approach to the initial assessment and management of time-sensitive conditions where early intervention saves lives
more
To test for ethnic discrimination in access to outpatient health
...
care services, we carry out
an email-correspondence study in Germany. We approach 3,224 physician offices in the 79
largest cities in Germany with fictitious appointment requests and randomized patients’
characteristics. We find that patients’ ethnicity, as signaled by distinct Turkish versus Ger-
man names, does not affect whether they receive an appointment or wait time. In contrast,
patients with private insurance are 31 percent more likely to receive an appointment. Hold-
ing a private insurance also increases the likelihood of receiving a response and reduces the
wait time. This suggests that physicians use leeway to prioritize privately insured patients
to enhance their earnings, but they do not discriminate persons of Turkish origin based
on taste. Still, their behavior creates means-based barriers for economically disadvantaged
groups.
more
The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited peopl
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e's movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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Access to NCD medicines: emergent issues during the COVID-19 pandemic and key structural factors
recommended
The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). This report examines the effect of the COVID-19 pandemic on a
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ccess to NCD medicines, and the policies and strategies implemented by countries and health systems to anticipate and mitigate stresses across NCD medicine supply chains. The full range of upstream and downstream impacts are investigated, including: manufacturing; procurement, importation and last mile delivery; patient-level effects through affordability and availability; and the effects on NCD medicine availability by category of disease. The report culminates in recommended actions and interventions for key stakeholders in the NCD pharmaceutical supply chain, including governments, regulatory authorities, manufacturers and the private sector; as well as directions for future research for improving access and supply chain access resilience.
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The availability of controlled medicines is crucial for patients requiring palliative care, pain relief and symptom management. Many individuals worldwide, especially in low- and middle-income countries, continue
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to experience limited access to these essential medicines. Enhancing access to controlled medicines is paramount in promoting universal health coverage. This report offers a detailed situational analysis of policies and programmes aimed at improving access to affordable, high-quality controlled medicines for pain management in the WHO South-East Asia Region. The report identifies the existing barriers, challenges and possible solutions to facilitate access to such medicines across all Member States.
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