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 presents a framework to link science, policy and practice for a comprehensive assessment of climate mitigation and adaptation investments and their impact on human health.The framework p...roposes to use weather and climate data to forecast health impacts over time, as well as biophysical and economic models to quantify the outcomes of investments in climate change adaptation and mitigation for relevant sectoral indicators and health co-benefits. It provides guidance on the economic valuation of health co-benefits of climate action, for inclusion in sector-specific cost–benefit analysis (CBA), including the spatial allocation of such costs and benefits.
The framework developed and presented in this study is comprehensive, and provides various entry points for different audiences, including decision-makers in the public and private sectors, researchers and scientists, working in the health sector as well as in other thematic areas and related sectors affected by climate action.
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The framework responds to the demand from Member States and partners for guidance on how the health sector and its operational basis in health syst...ems can systematically and effectively address the challenges increasingly presented by climate variability and change. This framework has been designed in light of the increasing evidence of climate change and its associated health risks (1); global, regional and national policy mandates to protect population health (2); and a rapidly emerging body of practical experience in building health resilience to climate change (3).
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The 2021 WHO health and climate change global survey report provides a valuable snapshot of the overall progress governments have made in addressing the health risks of climate change. The findings ...on key health and climate change indicators aim to empower policy makers to: make informed decisions on the implementation of policies and plans; identify evidence gaps; and better understand the barriers to achieving adaptation and resilience priorities in the health sector while maximizing the health benefits of sector-wide climate mitigation efforts.
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This document outlines the concept and content of the WHO people-centred approach to addressing antimicrobial resistance (AMR) in the human health sector. The proposed approach recognizes and aims t...o address the challenges and health system barriers people face when accessing health services to prevent, diagnose and treat (drug-resistant) infections. It puts people and their needs at the centre of the AMR response and guides policy-makers in taking programmatic and comprehensive actions to mitigate AMR in line with a proposed package of core interventions. These interventions are based on a review of four pillars and two foundational steps that are critical to overcome barriers faced by people and health systems in addressing AMR.
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The new WHO Guidelines on Sanitation and Health summarize the evidence on the effectiveness of a range of sanitation interventions and provide a comprehensive framework for health-protecting sanitat...ion, covering policy and governance measures, implementation of sanitation technologies, systems and behavioural interventions, risk-based management, and monitoring approaches. Critically, the guidelines articulate the role of the health sector in maximizing the health impact of sanitation interventions.
The guidelines also identify gaps in the evidence-base to guide future research efforts to improve the effectiveness of sanitation interventions.
(French, Spanish, Russian, Arabic in production)
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This document was prepared by UNICEF Regional Office for West and Central Africa, under the leadership of Christophe Valingot and the review of Joachim Peeters (WASH Specialist) and Arnaud Laillou (Nutrition Specialist), on behalf of the WASH Regional Group and the Nutrition Regional Group.
This ...WASH - Nutrition strategic guidance note for West and Central Africa builds on the precedent WASH-in-NUT strategy elaborated in 2012 and is the regional outcome of a multiyear collaborative work conducted at country level between 2018 and 2022, in Mali, Niger, Nigeria Chad, Burkina Faso. This work is based on a strong multi-partner collaboration, involving national technical directorates of the water and sanitation sector as well as technical directorates of Health and Nutrition, civil society organizations, national and international NGOs as well as United Nations agencies.
This document can serve as a technical and strategic guide for any partner wishing to strengthen the intersectorality of WASH-Nutrition programmes. It presents the regional WASH & Nutrition context, a brief review of the latest scientific evidence, and proposes an integrated WASH-Nutrition programming framework adapted to the regional context of West and Central Africa. Beyond the implementation of programmes, this document also calls for the explicit and concrete inclusion of WASH-Nutrition integration into national policy documents.
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As the culminating volume in the DCP3 series, volume 9 will provide an overview of DCP3 findings and methods, a summary of messages and substantive lessons to be taken from DCP3, and a further discussion of cross-cutting and synthesizing topics across the first eight volumes. The introductory chapte...rs (1-3) in this volume take as their starting point the elements of the Essential Packages presented in the overview chapters of each volume. First, the chapter on intersectoral policy priorities for health includes fiscal and intersectoral policies and assembles a subset of the population policies and applies strict criteria for a low-income setting in order to propose a "highest-priority" essential package. Second, the chapter on packages of care and delivery platforms for universal health coverage (UHC) includes health sector interventions, primarily clinical and public health services, and uses the same approach to propose a highest priority package of interventions and policies that meet similar criteria, provides cost estimates, and describes a pathway to UHC.
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The ICF Practical Manual provides information on how to use ICF. Anyone interested in learning more about use of the International Classification of Functioning, Disability and Health (ICF, WHO 2001) may benefit from reading this Practical Manual. T...he ICF is presently used in many different contexts and for many different purposes around the world. It can be used as a tool for statistical, research, clinical, social policy, or educational purposes and applied, not only in the health sector, but also in sectors such as insurance, social security, labour, education, economics, policy or legislation development, and the environment. People interested in functioning and disability and seeking ways to apply the ICF should find the contents of this Practical Manual helpful. The Practical Manual provides a range of information on how to apply ICF in various situations. It is built on the acquired expertise, knowledge and judgement of users in their respective areas of work, and is designed to be used alongside the ICF itself, which remains the primary reference.
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Int. J. Environ. Res. Public Health 2018, 15(12), 2626; https://doi.org/10.3390/ijerph15122626
Climate change is increasing risks to human health and to the ...box">health systems that seek to protect the safety and well-being of populations. Health authorities require information about current associations between health outcomes and weather or climate, vulnerable populations, projections of future risks and adaptation opportunities in order to reduce exposures, empower individuals to take needed protective actions and build climate-resilient health systems. An increasing number of health authorities from local to national levels seek this information by conducting climate change and health vulnerability and adaptation assessments. While assessments can provide valuable information to plan for climate change impacts, the results of many studies are not helping to build the global evidence-base of knowledge in this area. They are also often not integrated into adaptation decision making, sometimes because the health sector is not involved in climate change policy making processes at the national level. Significant barriers related to data accessibility, a limited number of climate and health models, uncertainty in climate projections, and a lack of funding and expertise, particularly in developing countries, challenge health authority efforts to conduct rigorous assessments and apply the findings. This paper examines the evolution of climate change and health vulnerability and adaptation assessments, including guidance developed for such projects, the number of assessments that have been conducted globally and implementation of the findings to support health adaptation action. Greater capacity building that facilitates assessments from local to national scales will support collaborative efforts to protect health from current climate hazards and future climate change. Health sector officials will benefit from additional resources and partnership opportunities to ensure that evidence about climate change impacts on health is effectively translated into needed actions to build health resilience.
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Background: The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Alt...hough health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future spending can be beneficial for policy makers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending. Methods: We extracted GDP, government spending in 184 countries from 1980–2015, and health spend data from 1995–2014. We used a series of ensemble models to estimate future GDP, all-sector government spending, development assistance for health, and government, out-of-pocket, and prepaid private health spending through 2040. We used frontier analyses to identify patterns exhibited by the countries that dedicate the most funding to health, and used these frontiers to estimate potential health spending for each low-income or middle-income country. All estimates are inflation and purchasing power adjusted.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia is pyramid in structure, with primary healthcare (...PHC) services at community level, at the base, followed by first and second level hospitals at district and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole.
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The COVID-19 pandemic has resulted in a double shock - health and economic. As of March 1, 2021, COVID-19 has cost more than 2.5 million lives and triggered an economic recession surpassing any economic downturn since World War II.
Part I of this p...aper explores the impact of this current macro-fiscal outlook on the three primary sources of health spending. Drawing on experiences from previous economic crises, scenario analyses suggest a fall in government per capita spending on health in 2021 and 2022 unless governments make bold choices to increase the share of health in general government spending.
Part II of the paper discusses policy options to meet the spending needs in health. These options encompass strategies to make fiscal adjustments work and channel funds where they are most needed, as well as policies to stabilize the balance sheets of social health insurance (SHI) schemes. The paper explains how the health sector can play an active role in expanding fiscal space, contributing to tax reforms, most importantly pro-health taxes, and mobilizing and absorbing external financing, including debt relief.
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A year ago, the second Special Session of the World Health Assembly (WHASS) unanimously agreed to start a diplomatic process for a new binding instrument aimed at ensuring the international community is better prepared for the next ...ibute-to-highlight medbox">health emergencies. The establishment of an Intergovernmental Negotiating Body (INB) at the WHO paved the terrain for a proper negotiation, which has started to unfold. The INB will be releasing the “conceptual zero draft” of the treaty text in early December 2022.
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