Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care syst...ems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primary 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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This report investigates the impact of potential misclassification of samples on HIV prevalence estimates for 23 surveys conducted from 2010-2014. In addition to visual inspection ...bute-to-highlight medbox">of laboratory results, we examined how accounting for potential misclassification of HIV status through Bayesian latent class models affected the prevalence estimates. Two types of Bayesian models were specified: a model that only uses the individual dichotomous test results and a continuous model that uses the quantitative information of the EIA (i.e., the signal-to-cutoff values). Overall, we found that adjusted prevalence estimates matched the surveys’ original results, with overlapping uncertainty intervals. This suggested that misclassification of HIV status should not affect the prevalence estimates in most surveys. However, our analyses suggested that two surveys may be problematic. The prevalence could have been overestimated in the Uganda AIDS Indicator Survey 2011 and the Zambia Demographic and Health Survey 2013-14, although the magnitude of overestimation remains difficult to ascertain. Interpreting results from the Uganda survey is difficult because of the lack of internal quality control and potential violation of the multivariate normality assumption of the continuous Bayesian latent class model. In conclusion, despite the limitations of our latent class models, our analyses suggest that prevalence estimates from most of the surveys reviewed are not affected by sample misclassification.
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The escalating antimicrobial resistance (AMR) pandemic is a global public health threat with extensive health, economic and societal implications. Resistance emerges because ...o-highlight medbox">of selection pressure from rational and indiscriminate antimicrobial use in human health as well as in the veterinary, agriculture and environmental sectors. Infections caused by resistant bacteria result in longer duration of illness, higher mortality rates and increased costs associated with alternative treatment. AMR further constrains procedures that rely on antimicrobial prophylaxis, and AMR is recognized as a threat to theworld economy.
Journal of Public Health | Vol. 39, No. 1, pp. 8–13 | doi:10.1093/pubmed/fdw015 | Advance Access Publication March 3 2016
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Background paper for the Oslo Summit on Education for Development
Vol. 7, No. 1 (2018) | ISSN 2166-7403 (online) DOI 10.5195/cajgh.2018.295 | http://cajgh.pitt.edu
4th edition 2022 of the Handbook includes new WHO recommendations that expand contraceptive choices. Also, guidance on starting ongoing contraception following emergency contraception is provided.
Drawing on lessons from rec...ent outbreaks, this new edition details tangible measures for frontline health workers to protect access to family planning services during emergencies, such as wider access to self-administered contraceptives and the use of digital technologies by providers. It also expands guidance for women and young people at high risk of HIV.
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Recommendations on the initiation and continuing use of nine common types of contraceptive methods are covered by the tool. In addition to looking at individual medical conditions or characteristics..., users may also easily combine multiple conditions or characteristics and view the guidance on each condition separately or in combination.
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This toolkit aims to provide you with a brief introduction of what SA and its core principles are, and how you as a student can apply several of the existing tools for your own school to... really make a difference.
French, Spanish and Arabic Version available: https://ifmsa.org/social-accountability/
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PLOS ONE | https://doi.org/10.1371/journal.pone.0192765 February 23, 2018
The objectives of the meeting were to agree on coordinated and aligned support to the 3 countries’ national health recovery plans (Guinea, Liberia, Sierra Leone); to identify cross-cutting areas a...nd opportunities for integration; to identify ways to improve implementation modalities; and to identify actions including technical assistance needed to support the countries in the process of building resilient health systems.
The outcomes of the meeting consisted in proposed country action plans to move forward with the implementation of the recovery plans. The action plans includes:priorities and areas of work; activities needed to improve implementation modalities; technical assistance needs.
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(August 28 – October 10, 2017)
A nutrition and mortality assessment using SMART methodology was applied and the survey covered 15 statistical (14 districts plus 1) domains countrywide. The main objective of the survey was to assess the curren...t nutrition status of the population, especially children 6-59 months old and women of reproductive age (15-49 years of age). The survey also looked at the major contextual factors contributing to undernutrition such as infant and young child feeding (IYCF) practices; food security indicators; water, sanitation and hygiene indicators; and health situation in Sierra Leone
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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.
Review of disability issues and rehabilitation services in 29 african countries.
Purpose of this document: to present eight practical steps that Member States can take at the national and sub-national level to improve WASH in health care facilities
Collection of country-level good practices
Development of one or more vaccines for Neisseria gonorrhoeae is an important objective for sexual and reproductive health worldwide, and for the fight against antimicrobial resistance.
WHO prefe...rred product characteristics (PPCs) provide strategic guidance as to WHO’s preferences for new vaccines in priority disease areas. PPCs are intended to encourage innovation and development of vaccines for use in settings most relevant to the global unmet public health need.
Gonococcal vaccine PPCs describe global public health goals for gonococcal vaccines and preferred parameters pertaining to vaccine indications and target populations, safety and efficacy considerations, and immunization strategies.
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This document is part of the process for improving the quality of care in family planning. Medical eligibility criteria for contraceptive use (MEC), the first edition ...ight medbox">of which was published in 1996, prsents current World Health Organization (WHO) guidance on the safety of various contraceptive e-
methods for use in the context of specific health conditions and characteristics. This is the fifth edtion of the MEC –the latest in the series of periodic updates
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