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1
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 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.
more
This report makes the case for a major new initiative—to rapidly recruit, train and deploy 2 million community health workers in Africa. Drawing on a vast body of evidence and substantial regional experience, the report shows how community
...
health workers save lives and improve quality of life and how investments in community health workers effectively harness the demographic dividend, reduce gender inequality and accelerate economic growth and development. Indeed, the benefits of community health workers stretch from one end of the Agenda for Sustainable Development to the other.
more
WHO is launching a “Revised edition, 2021” for the Caring for women subjected to violence: A WHO training curriculum for health-care providers today. The revised edition includes 4 new modules three of which are for
...
health managers to assess and strengthen health facility readiness and one module, which is for managers and providers to support prevention of violence against women. The earlier content published in 2019 remains unchanged. The 2021 edition is aimed at creating an enabling health systems environment for health workers to provide quality care to women subjected to violence.
more
This South-East Asia Regional Strategy for Primary Health Care: 2022-2030 aims to accelerate progress in all countries of the Region towards universal health coverage (UHC),
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health security and the health-related Sustainable Development Goals (SDGs). It is intended to provide Member States with guidance on facilitating PHC-orientation through the identification of seven values and 12 strategic actions that collectively embody the philosophy and practice of PHC, enunciated in the 1978 Declaration of Alma-Ata and reaffirmed in the 2018 Declaration of Astana.
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The COVID-19 pandemic has led to large increases in healthcare waste, straining under resourced healthcare facilities and exacerbating environmental impacts from solid waste. This report quantifies the additional COVID-19 healthcare waste generated, describes current healthcare waste management syst
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ems and their deficiencies, and summarizes emerging best practices and solutions to reduce the impact of waste on human and environmental health. The recommendations included in the report build on actions in the WHO manifesto for a healthy recovery from COVID-19: prescriptions and actionables for a healthy and green recovery. They target the global, national and facility levels to promote a “win–win” scenario for COVID-19 PPE use, testing and vaccinations that are safe and support environmental sustainability.
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Countries reported disruptions in all health-care settings. In more than half of countries surveyed, many people are still unable to access care at the primary care and community care levels. Significant disruptions have also been reported in emerg
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ency care, particularly concerning given the impact on people with urgent health needs. Thirty-six per cent of countries reported disruptions to ambulance services; 32% to 24-hour emergency room services; and 23% to emergency surgeries.
Elective surgeries have also been disrupted in 59% of countries, which can have accumulating consequences on health and well-being as the pandemic continues. Disruptions to rehabilitative care and palliative care were also reported in around half of the countries surveyed.
Major barriers to health service recovery include pre-existing health systems issues which have been exacerbated by the pandemic as well as decreased demand for care.
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Shortages of healthcare workers is detrimental to the health of communities, especially children. This paper describes the process of capacity building Community Health Volunteers (CHVs) to deliver
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integrated preventive and curative package of care of services to manage common childhood illness in hard-to-reach communities in Bondo Subcounty, Kenya
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The Government of Kenya, through the Ministry of Health, has the
constitutional obligation to provide the highest level of health care for its
citizens. The Ministry of
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Health’s review of the 2015 Policy document
on infection prevention and control (IPC) is in line with that goal.
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The WHO Global strategy on human resources for health: workforce 2030 encourages development partners and global health initiatives to leverage their support to
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health systems in countries to sustainably strengthen the health workforce. To assess the impact of these investments, a methodology was developed and pilot tested by WHO.
The impact assessment tool (consisting of an MS Excel calculator with two subsets) supports users to:
• assess and quantify the health impact of HRH investments made in the context of HIV, tuberculosis (TB) and malaria programmes through their modelled effect on health service coverage of these three diseases; and
• provide aggregate indicative estimates of the range of health workers required to attain high coverage of selected health services.
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This report contains the results of an in-depth Training Needs Assessment (TNA) of Health Workers in the 4 project counties of the republic of Kenya – Nakuru, Kisumu, Nairobi and Bungoma. The assessment, facilitated by the UPOPs Project in close c
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ollaboration with the Ministry of Health and Ministry of Environment and Natural Resources, took place in the month of September 2017. This assessment focused on health workers at County and County referral health facilities.
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This report has been prepared in response to informal requests by SIDS Member States and territories for WHO assistance in confronting the stark and dire situation which climate change has created in their countries and the impact it is having on their peoples
Guide for the Medical, Veterinary and allied Professions
Bishop, G.; Durrheim, D.; Kloeck, P. et al.
Department: Agriculture, Foresty and Fisheries - Republic of South Africa
(2010)
CC
Rabies is a disease of animals but too often the outcome is gauged in terms of human suffering and
death. Despite this, in areas of the world where rabies is endemic there is often a lack of communication between veterinary and medical professionals, to the extent that the disease continues to thri
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ve and potential victims are not treated. The problem is partly
exacerbated by a lack of awareness and experience of the disease and of what to do when confronted by suspect cases. In these technologically advanced days, although it is possible to learn “all there is to know” about almost any subject, it is sometimes difficult to distil the essence.
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Today, patient harm due to unsafe care is a large and growing global public health challenge and is one of the
leading causes of death and disability worldwide. Most of this patient harm is avoidable. As countries strive to
achieve universal
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health coverage and the Sustainable Development Goals, the beneficial effects of improved
access to health services can be undermined by unsafe care. Patient safety incidents can cause death and
disability, and suffering for victims and their families. The financial and economic costs of safety lapses are high.
There is often reduced public confidence and trust in local health systems when such incidents are publicized.
Health workers involved in serious incidents involving death or serious harm to a patient can also suffer lasting
psychological harm and deep-seated feelings of guilt and self-criticism.
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Rebuilding Liberia’s health system is crucial for improving the country’s overall health outcomes. This annual report highlights key achievements, challenges,and lessons learned in implementi
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ng programmes of technical cooperation with the Government of Liberia from January to December 2022. The key achievements are summarized under the thematic areas of Universal Health Coverage, Health Emergencies and Corporate and Enabling Support.
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The WHO Disability-Inclusive Health Services Training Package is a companion to the “WHO Disability-Inclusive Health Services Toolkit: A resource for he
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alth facilities in the Western Pacific Region” published by WHO in 2020. This package offers a range of additional training materials including presentations, workbooks and videos that will allow users to develop the foundational skills and understanding of the Toolkit for its implementation. Together the Toolkit and Training Package will help ensure equitable access to health services, best-quality outcomes and improved quality of life for all people with disabilities to achieve universal health coverage.
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This toolkit was developed to provide detailed information and resources to support implementation of the WHO intrapartum and immediate postnatal care recommendations at the health-care facility level. The careful design of this toolkit is based on
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a rigorous evidence-based approach that includes implementation strategies of proven effectiveness to help close the gap between WHO’s care recommendations and current policies and practices.
The primary target audience for the toolkit includes policy-makers, health-care facility managers, implementers and managers of maternal and child health programmes, nongovernmental organizations (NGOs) and professional societies involved in the planning and management of maternal and child health services.
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The Community-based Health System Model Series briefs identify and discuss critical health system inputs and processes that have contributed to the implementation and expansion of community-based se
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rvice delivery in different countries.
Countries were selected for their geographic diversity, type of service delivery model, and programmatic scale-up.
This brief reviews Malawi’s community health model to inform future policy, program design, and implementation in other countries.
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