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Publication Years
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Toolboxes
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The ICOPE guidance for person-centred assessment and pathways in primary care (ICOPE Handbook) helps community health and
...
care workers put the recommendations outlined in the ICOPE Guidelines into practice. The Handbook assists with setting person-centred goals, screening for loss in a range of domains of intrinsic capacity and assessing health and social care needs to develop a personalised care plan. The care plan may include multiple interventions to manage declines in intrinsic capacity, provide social care and support, support self-management and support caregivers. The domains of intrinsic capacity include cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss and depressive symptoms.
more
The manual has been designed in a comprehensive manner, the aim being to provide a holistic approach to the short-term development of human resources, with a focus on primary care physicians. This i
...
s a reference manual meant for primary care physicians who will provide care to older people in primary health care facilities. The information on old age care is meant to be incorporated into the everyday clinical practice of primary care physicians. This manual will help to enhance the knowledge and skills of physicians. It is expected that the use of the manual will improve the approach to issues of old age and promote holistic care of older people, which will ultimately improve their quality of life.
more
Policy brief, 24 July 2020
The COVID-19 pandemic has affected older people disproportionately, especially those living in long-term care facilities. In many countries, evidence shows that more than 40% of COVID-19 related deaths have been linked to
...
long-term care facilities, with figures being as high as 80% in some high-income countries. Concerted action is needed to mitigate the impact across all aspects of long-term care, including home- and community-based care, given that most users and providers of care are those who are vulnerable to severe COVID-19.
This policy brief provides 11 policy objectives and key action points to prevent and manage COVID-19 across long-term care. Its intended audience is policy makers and authorities (national, subnational and local) involved in the COVID-19 pandemic. The brief builds on currently available evidence on the measures taken to prevent, prepare for and respond to the COVID‑19 pandemic across long-term care services including care providers
more
Community Discussion Guide for Maternal and Newborn Health Care
Mobilising Access to Maternal Health Services in Zambia Programme, District Health Management Teams
UK Aid; Health Partner International, MOH Zambia
(2012)
C1
A training manual for safe motherhood action groups (MAMaZ)
National Guidelines for Home Based Care Services
Ministry of Health and Social Welfare, National AIDS Control Programme, Tanzania
Ministry of Health and Social Welfare, Tanzania
(2010)
C1
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 implement
...
ation resources initially developed for acute health 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.
more
National Tuberculosis and Leprosy Control Program
Maintaining and improving quality of care within HIV clinical services - Technical Brief
World Health Organization
(2019)
C_WHO
HIV Treatment
Management, control and prevention of tuberculosis - Guidelines for health care providers
Prof. C. Abobltins, L. Brown, Prof N. Curtis, et al.
Department of Health & Human Services; State Goverment Victoria
(2015)
C2
WHO alcohol brief intervention training manual for primary care
World Health Organization (Europe)
(2017)
C_WHO
Alcohol contributes significantly to the disease and mortality burden in the WHO European Region, and primary health care systems play an important
...
role in reducing the impact of harmful alcohol use. Screening and brief interventions (SBIs) for alcohol are an evidence-informed approach to addressing the needs of the many patients presenting in primary care who may benefit from reducing their alcohol consumption. This manual provides information to plan training and support for primary care practitioners to confidently deliver SBI for alcohol problems to their patients. The manual outlines the background and evidence base for SBI, and gives practical advice on establishing an implementation programme as well as detailed educational materials to develop the knowledge and skills of participants in organized training sessions.
more
The ICOPE Implementation Framework provides a score card to help assess the overall capacity of health and social care services and systems to deli
...
ver integrated care in community settings and support the development of ICOPE implementation action plans. There are 19 actions needed to implement ICOPE on the services level (meso) and systems level (macro). The scoring process provides an evidence-based means of highlighting areas for improvement as well as establishing concrete measures of future improvements
more
This handbook is an adaptation from the WHO Clinical Handbook Health care for women subjected to intimate partner violence or sexual violence developed by the World
...
Health Organization (WHO), UN Women and United Nations Population Fund. The handbook draws on the work from professionals who are dedicated to preventing and responding to Gender Based Violence.
The Handbook guides health care service providers to provide comprehensive services to survivors of intimate partner violence and/or sexual violence. It also guides health professionals with respect to relevant stakeholders for referral purposes. The purpose is to ensure that relevant authorities are informed timeously in order act and ensure that those affected by violence receive speedy service as required.
more
Consolidated Guidelines
Geneva, 2016
The End TB Strategy
The END TB Strategy
Интеграция совместного оказания услуг в связи с ТБ и ВИЧ во всеобъемлющий пакет помощи для потребителей инъекционных наркотиков
Metrics for monitoring the cascade of HIV testing, care and treatment services in Asia and the Pacific
World Health Organization; USAID; CDS
(2014)
C_WHO
Community Health Worker Assessment and Improvement Matrix (CHW AIM): A Toolkit for Improving CHW Programs and Services
L. Crigler; K. Hill; R. Furth; et al.
USAID From the American People (Health Care Improvement Project)
(2013)
C2
Revided Version
September 2013
National Guideline for Health Care Provider On Infection Prevention and Control of COVID-19 pandemic in Healthcare Setting
Ministry of Health & Family Welfare of Bangladesh, Directorate General of Health Services
Ministry of Health & Family Welfare of Bangladesh, Directorate General of Health Services
(2020)
C2
Version: 2.0 Date: 19.3.2020
A cross-sectional descriptive study design covering all states and regions was undertaken to:
1) To assess availability, utilization and supply chain management system for RH commodities at different levels of health facilities,
2) To ass ... ess quality of RH services with emphasis on family planning in terms of training, supervision, use of guidelines and ICT, and
3) To determine clients’ accessibility to RH services provided at different level of facilities. more
1) To assess availability, utilization and supply chain management system for RH commodities at different levels of health facilities,
2) To ass ... ess quality of RH services with emphasis on family planning in terms of training, supervision, use of guidelines and ICT, and
3) To determine clients’ accessibility to RH services provided at different level of facilities. more
Supplement Article
J Acquir Immune Defic Syndr Volume 75, Supplement 2, June 1, 2017 www.jaids.com
Policy
July 2012
Working Paper No. 3
Bulletin of the World Health Organization; Type: Perspectives
Article ID: BLT.19.24843
Gurejeet al. BMC Health Services Research (2015) 15:242
DOI 10.1186/s12913-015-0911-3
This report explores community-focused change initiatives in the financing, organization, and delivery of mental health services in Peru from 2013 to 2016. It examines the national dimension of refo
...
rms but focuses above all on implementation and results in the economically fragile district of Carabayllo, in northern Lima.
more
Community health workers in Lesotho: Experiences of health promotion activities
T. Seutloali; L. Napoles; N. Bam
African Journal of Primary Health Care & Family Medicine; AOSIS
(2018)
C2
African Journal of Primary Health Care & Family Medicine
ISSN: (Online) 2071-2936, (Print) 2071-2928
Impact of health systems strengthening on coverage of maternal health services in Rwanda, 2000–2010: a systematic review
Maurice Bucagu, Jean M. Kagubare, Paulin Basinga, Fidèle Ngabo, Barbara K Timmons & Angela C Lee
Reproductive Health Matters
(2012)
CC
From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Develop
...
ment Goal 5, among many other improvements in national health. Based on a systematic review of the literature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
more
BMC Health Services Research (2017) 17:623 DOI 10.1186/s12913-017-2567-7
JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE, Vol. 28, No. 2, March/April 2017, 186-198
http://dx.doi.org/10.1016/j.jana.2015.09.003
The WHO Quality Toolkit: Navigating tools to improve the quality of health services helps easy identification and access to a wide range of WHO published materials to improve the quality of
...
health services. These tools support the actions described in the Quality health services: a planning guide, which outlines a structured, systems-based approach to improving quality of health services. Whether you work at the facility, sub-national or national level, or in specific communities, you will find resources within the Quality Toolkit to help you carry out essential tasks to improve quality of care
more
Human resources for health in Botswana
Nkomazana, O., Peersman, W., Willcox, M., et al.
African Journal of Primary Health Care & Family Medicine (PHCFM)
(2014)
CC
The results of in-country database and reports analysis
This document highlights the key aspects of safe health-care waste management in order to guide policy-makers, practitioners and facility managers to improve such
...
services in health-care facilities. It is based on the comprehensive WHO handbook Safe management of wastes from health-care activities (WHO, 2014), and also takes into consideration relevant World Health Assembly resolutions, other UN documents and emerging global and national developments on water, sanitation and hygiene and infection prevention and control.
more
1 June 2020
Countries around the world are facing the challenge of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delivery of
...
health care for all conditions. Maintaining essential health services: operational guidance for the COVID-19 context recommends practical actions that countries can take at national, subregional and local levels to reorganize and safely maintain access to high-quality, essential health services in the pandemic context. It also outlines sample indicators for monitoring essential health services, and describes considerations on when to stop and restart services as COVID-19 transmission recedes and surges. This document expands on the content of pillar 9 of the COVID-19 strategic preparedness and response plan, supersedes the earlier Operational guidance for maintaining essential health services during an outbreak, and complements the recently-released Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic. It is intended for decision-makers and managers at the national and subnational levels.
This is an update to COVID-19: Operational guidance for maintaining essential health services during an outbreak: Interim guidance, 25 March 2020
more
Training for Health Care Providers
Facilitators’ Manual
Countries around the world are facing the challenge of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delivery of health
...
care for all conditions. Maintaining essential health services: operational guidance for the COVID-19 context recommends practical actions that countries can take at national, subregional and local levels to reorganize and safely maintain access to high-quality, essential health services in the pandemic context. It also outlines sample indicators for monitoring essential health services, and describes considerations on when to stop and restart services as COVID-19 transmission recedes and surges.
more
Providing quality, stigma-free services is essential to equitable health care for all and achieving global HIV goals and broader Sustainable Develo
...
pment Goals related to health. Every person has the right to the highest attainable standard of physical and mental health. Countries have a legal obligation to develop and implement legislation and policies that guarantee universal access to quality health services and address the root causes of health disparities, including poverty, stigma and discrimination.
The health sector is uniquely placed to lead in addressing inequity, assuring safe personcentred care for everyone and improving social determinants of health by overcoming taboos and discriminatory or stigmatizing behaviours associated with HIV, viral hepatitis and sexually transmitted infections (STIs). Improving health care quality and reducing stigma work together to enhance health outcomes for people living with HIV. Together, they make health care services more accessible, trustworthy and supportive. This encourages early diagnosis, consistent treatment and improved mental well-being. Thus, people living with HIV are more likely to engage with and benefit from health care services, leading to improved overall health.
more
The report identifies major global gaps in WASH services: one third of health care facilities do not have what is needed to clean hands where
...
care is provided; one in four facilities have no water services, and 10% have no sanitation services. This means that 1.8 billion people use facilities that lack basic water services and 800 million use facilities with no toilets. Across the world’s 47 least-developed countries, the problem is even greater: half of health care facilities lack basic water services. Furthermore, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning.
This report also describes the global and national responses to the 2019 World Health Assembly resolution on WASH in health care facilities. More than 70% of countries have conducted related situation analyses, 86% have updated and are implementing standards and 60% are working to incrementally improve infrastructure and operation and maintenance of WASH services. Case studies from 30 countries demonstrate that progress is being propelled by strong national leadership and coordination, use of data to direct resources and action, and the mutual benefits of empowering health workers and communities to develop solutions together.
more
Catholic hospitals and other health services provide invaluable care to many in the community. This article accentuates the pastoral nature of Cath
...
olic health care, which is definitive to its Catholic identity. Discussing contemporary Catholic health care in conjunction with the works of Henri Nouwen we explore the challenges faced by today’s Catholics in Catholic health care and respond to these issues. In support of the discussion are the results of qualitative research into the perceptions Perth parishioners have of Catholic health care’s pastoral nature and Catholic identity. This research aims towards understanding the challenges facing Catholic health care providing pastoral care within its Catholic identity.
more
Primary care visits may be a time that refugee families express concerns about their child’s functioning at home or school and/or providers may identify concerns about emotional or behavioral
...
health. Most refugee children have experienced trauma which may affect their emotional, behavioral, and physical development. However, many refugee children are resilient
and may not exhibit symptoms related to trauma.
more
National Strategy and Action Plan for Clubfoot Care in Bangladesh
Dr. A. M. Z. Hussain; Dr. Rizvi; Dr. Qavi; et al.
Government of the People's Republic of Bangladesh DGHS Directorate General of Health Services Ministry of Health and Family Welfare ; Sustainable Clubfoot Care in Bangladesh
(2015)
C2
December 2015
National guidelines for of Clubfoot
After a decade of crisis, Syria remains one of the world’s most complex humanitarian crises. Continued hostilities, new and protracted displacement, increased returns and the sustained destruction of communities have impacted Syrians’ lives and futures in a devastating way. The 2021 Humanitarian
...
Needs Overview (HNO) identified that 13.4 million people, more than half of country’s pre-crisis population, need humanitarian support. Of this figure, 12.4 million require health care.
more
The WHO Quality Health Services: a planning guide focuses on actions required at the national, district and facility levels to enhance quality of health
...
services, providing guidance on implementing key activities at each of these three levels. It highlights the need for a health systems approach to enhance quality of care, with a common understanding on the activities needed by all stakeholders. The guide articulates the key actions required to improve the quality of health services for the entire population. It recognizes that the path varies for each country, district and facility – stimulating the reader to consider multiple factors and entry points for action. This planning guide is for staff working at all levels of the health system (i.e. national, district and facility) who have a role in enhancing the quality of health services. It is also relevant to all stakeholders initiating and supporting action at facility, district and/or national levels both in the public and private sectors.
more
Lessons learned in developing community mental health care in Latin American and Caribbean countries
This paper summarizes the findings for the Latin American and Caribbean countries of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care
...
. It presents an overview of the provision of mental health services in the region; describes key experiences in Argentina, Belize, Brazil, Chile, Cuba, Jamaica and Mexico; and discusses the lessons learned in developing community mental health care.
more
Following the 2014 Euromaidan Revolution, Ukraine embarked on a national reform program to reduce widespread corruption within government. In the health sector, the government introduced several complementary reforms that aimed to improve the
...
health outcomes of Ukrainian citizens, but designed in such a way that they would also reduce corruption. The reforms included reconfiguring primary care financing and essential medicines reimbursement under the newly formed National Health Service of Ukraine; raising the remuneration of health professionals; introducing a transparent, merit-based, process for medical university admissions; and initiating development of an eHealth digital records system.
more
Self-care interventions are among the most promising and exciting new approaches to improve health and well-being, both from a health systems persp
...
ective and for people who use these interventions.
The World Health Organization (WHO) uses the following working definition of self-care: Self-care is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker. The scope of self-care as described in this definition includes health promotion; disease prevention and control; self-medication; providing care to dependent persons; seeking hospital/specialist/primary care if necessary; and rehabilitation, including palliative care. It includes a range of self-care modes and approaches. While this is a broad definition that includes many activities, it is important for health policy to recognize the importance of self-care, especially where it intersects with health systems and health professionals.
more
Community-based health care, including outreach and campaigns,in the context of the COVID-19 pandemic
recommended
The COVID-19 pandemic is challenging health systems across the world. Rapidly increasing demand for care of people with COVID-19 is compounded by fear, misinformation and limitations on the movement
...
of people and supplies that disrupt the delivery of frontline health care for all people...
This guidance addresses the specific role of community-based health care in the pandemic context and outlines the adaptations needed to keep people safe, maintain continuity of essential services and ensure an effective response to COVID-19. It is intended for decision-makers and managers at the national and subnational levels and complements a range of other guidance, including that on priority public health interventions, facility-based care, and risk communication and community engagement in the setting of the COVID-19 pandemic.
more
Infection prevention and control (IPC) practices are of critical importance in protecting the function of healthcare services at all levels and mitigating the impact on vulnerable populations. Although the management of possible COVID-19 cases is us
...
ually guided by national policies for specific healthcare facilities, community transmission is currently widespread in most EU/EEA countries and the UK, therefore primary healthcare providers in the community such as GPs, dentists and pharmacists are at risk of being exposed to COVID-19.
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
...
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.
more
Government of Nepal has an obligation to ensure availability of affordable and high quality basic health care services to its population
Towards Sustainable Community Health and Social Welfare Services
Leaving No One Behind. This Operational Guideline for Community-Based Health
...
Services (CBHS)
in line with the CBHS Policy Guideline map an integrated and coordinated
national approach to community-based health services in Tanzania. The
approach builds on and furthers national priorities for decentralization,
community empowerment and strengthened systems for expansion of
access to essential health services at the village level and below.
more
WHO Guideline on self-care interventions for health and well-being, 2022 revision: executive summary
recommended
A global shortage of an estimated 18 million health workers is anticipated by 2030, a record 130 million people are in need of humanitarian assistance, and there is the global threat of pandemics such as COVID-19. At least 400 million people worldwi
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de lack access to the most essential health services, and every year 100 million people are plunged into poverty because they have to pay for healthcare out of their own pockets. There is, therefore, an urgent need to find innovative strategies that go beyond the conventional health-sector response.
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This report presents, for the first time, a global assessment of the extent to which health care facilities provide essential water, sanitation and hygiene (WASH)
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services. Drawing on data from 54 low- and middle-income countries, the report concludes that 38% lack access to even rudimentary levels of water, 19% lack sanitation and 35% do not have water and soap for handwashing. When a higher level of service is factored in, the situation deteriorates significantly. A number of areas require urgent action and WHO will work with UNICEF, Governments and other partners to develop a global plan to address the most pressing needs and ensure that all health care facilities have WASH services.
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PLoS Med 16(3): e1002768. https://doi.org/10.1371/journal.pmed.1002768
Home delivery and late and infrequent attendance at antenatal care (ANC) are responsible for substantial avoidable maternal and pediatric morbidity and mortality in sub-Saharan
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Africa. This cluster-randomized trial aimed to determine the impact of a community health worker (CHW) intervention on the proportion of women who visit ANC fewer than 4 times during their pregnancy and deliver at home.
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In order to maintain daily operations and patient care services, health care facilities need to
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develop an Emergency Water Supply Plan (EWSP) to prepare for, respond to, and recover from a total or partial interruption of the facilities’ normal water supply. Water supply interruption can be caused by several types of events such as natural disaster, a failure of the community water system, construction damage or even an act of terrorism.
The planning guide provides a four step process for the development of an EWSP:
1. Assemble the appropriate EWSP Team and the necessary background documents for your facility;
2. Understand your water usage by performing a water use audit;
3. Analyze your emergency water supply alternatives; and
4. Develop and exercise your EWSP more
The planning guide provides a four step process for the development of an EWSP:
1. Assemble the appropriate EWSP Team and the necessary background documents for your facility;
2. Understand your water usage by performing a water use audit;
3. Analyze your emergency water supply alternatives; and
4. Develop and exercise your EWSP more
Inequalities in maternal health care utilization in Benin: a population based cross-sectional study
Sanni Yaya , Olalekan A. Uthman, Agbessi Amouzou, Michael Ekholuenetale, Ghose Bishwajit
BMC Pregnancy and Childbirth
(2018)
C2
Yaya et al. BMC Pregnancy and Childbirth (2018) 18:194
Ensuring equitable access to maternal health care including antenatal, delivery, postnatal servi
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ces
and fertility control methods, is one of the most critical challenges for public health sector. There are significant
disparities in maternal health care indicators across many geographical locations, maternal, economic, sociodemographic
factors in many countries in sub-Sahara Africa. In this study, we comparatively explored the utilization
level of maternal health care, and examined disparities in the determinants of major maternal health outcomes
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Investment in all the drivers and facilitators of hand hygiene action in health care to ensure that it occurs at the point of care and other critic
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al moments requires a multidisciplinary, multifaceted approach. WHO describes such an approach as a “multimodal improvement strategy” (MMIS) which is at the core of its implementation models for hand hygiene and infection prevention and control (IPC) programmes. The focus of this document is on the resource considerations for investing in hand hygiene improvement in health care (primary, secondary and tertiary) using the MMIS approach.
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Over the past two decades, Afghanistan has depended on international donor support to fund essential services like health care. But this donor supp
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ort has been falling for years and will likely to continue do so—perhaps precipitously—following the announcement by United States President Joe Biden that the US will withdraw all US forces from Afghanistan by September 11, 2021. This decline in funding has already had a harmful—and life-threatening—impact on the lives of many Afghan women and girls, as it affects access to, and quality of, health care.
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A corruption event in 2009 led to changes in how donors supported the Zambian health system. Donor funding was withdrawn from the district basket mechanism, originally designed to pool donor and government financing for
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primary care. The withdrawal of these funds from the pooled financing mechanism raised questions from Government and donors regarding the impact on primary care financing during this period of aid volatility.
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Unpreparedness of health professionals to address non-communicable diseases (NCD) at peripheral health facilities is a critical health system chall
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enge in Mozambique. To address this weakness and decentralize NCD care, training of the primary care workforce is needed. We describe our experience in the design and implementation of a cascade training of trainers (ToT) intervention to strengthen the prevention and control of cardiovascular disease.
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People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to
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health care services. This qualitative study explores the barriers to health care access experienced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside a mobility or sensory impairment, on health care accessibility is explored.
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Health worker roles in providing safe abortion care and post-abortion contraception
World Health Organization
(2015)
Planned and regulated task shifting and task sharing can have a range of benefits. It can ensure a rational optimization of the available health workforce, address health system shortages of special
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ized health-care professionals, improve equity in access to health care and increase the acceptability of health services for those receiving them. This guideline provides a range of options for expanding of health worker roles in the provision of safe abortion care, the management of complications of abortion (also known as post-abortion care in some settings and provided as part of emergency obstetric care) and for post-abortion contraception provision.
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Private health sector assessment: selected health products and services in Sénégal
Brunner B., J. Barnes, A. Carmona et. al.
United States Agency for International Development
(2016)
C2
USAID Senegal and Health in Africa (HIA) initiative of the World Bank Group engaged the Strengthening Health Outcomes through the Private Sector (SHOPS) project to conduct an assessment of the priva
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te health sector in Senegal. The assessment’s primary focus is family planning, and its secondary focus is maternal, neonatal and child health (MNCH), HIV and AIDS, malaria, and nutrition.
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Supporting the continuity of health and nutrition services in the context of COVID-19 in refugee settings
recommended
The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number of deaths caused by malaria, HIV/AIDS, and tuberculosis attributable to
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health system failures exceeded deaths from Ebola.
With a relatively limited COVID-19 caseload, health systems may have the capacity to maintain routine service delivery in addition to managing COVID-19 cases. When caseloads are high, and/or health workers are directly affected, strategic adaptations are required to ensure that increasingly limited resources provide maximum benefit for the refugees and surrounding host population. The following are key considerations for UNHCR operations on prioritized health care services in the event of a COVID-19 outbreak. These are based on WHO Guidance for Maintaining Essential Health Services and UNHCR guidance for operations and where relevant operation or site level outbreak preparedness and response plans.
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WHO Guidance for Climate Resilient and Environmentally Sustainable Health Care Facilities
recommended
The aim of this guidance is to enhance the capacity of health care facilities to protect and improve the health of their target communities in an u
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nstable and changing climate; and to empower health care facilities to be environmentally sustainable, by optimizing the use of resources and minimizing the release of waste into the environment. Climate resilient and environmentally sustainable health care facilities contribute to high quality of care and accessibility of services, and by helping reduce facility costs also ensure better affordability. They are, therefore, an important component of universal health coverage (UHC).
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Monitoring financial protection and utilization of health services in Mongolia 2009-2018 is based on national representative household socioeconomic surveys. The study finds that between 2009 and 20
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18, despite ambitious health reforms, the incidence of catastrophic health spending and impoverishing spending at the relative poverty line have increased. These increases were mainly driven by out-of-pocket spending on medicines and inpatient care. In the same period, inequity in access to and utilization of health services remained constant among population groups. Evidence suggests health financing policies need to be further strengthened to make progress towards universal health coverage. Continuous tracking of out-of-pocket payments and service utilization to inform policymaking is needed.
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The "Primary Healthcare Standard Treatment Guidelines and Essential Medicines List" by the South African National Department of Health provides evidence-based guidelines for diagnosing and managing
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common medical conditions at the primary healthcare level. This document includes treatment protocols for various health issues, such as infections, chronic diseases, maternal and child health, mental health, and emergency care. It aims to standardize care, promote rational medicine use, and ensure equitable access to essential medications across South Africa. The guidelines emphasize prevention, accurate diagnosis, and efficient treatment strategies to improve patient outcomes.
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In recent decades, there have been concerted efforts to improve mental health services for youths alongside the challenges of rising healthcare costs and increasing demand for mental
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health needs. One important phenomenon is the shift from traditional clinic-based care to community based mental health services to improve accessibility to services and provide patient-centred care. In this article, we discuss the child and adolescent community mental health efforts within the Asia-Pacific region.
Brain Sci.2017,7, 126; doi:10.3390/brainsci7100126
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nt. J. Environ. Res. Public Health 2014, 11(12), 13097-13116; https://doi.org/10.3390/ijerph111213097
Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact
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health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change.
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To test for ethnic discrimination in access to outpatient health care services, we carry out
an email-correspondence study in Germany. We approach
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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.
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and
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outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimate the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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Design and Implementation of a Community Health Worker HIV Treatment and Prevention Intervention in an HIV Hotspot Fishing Community in Rakai, Uganda
A. Long; I. Mbabali; H. E. Hutton et al.
Journal of the International Association of Providers of AIDS Care; Department of Health & Human Services USA
(2017)
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J Int Assoc Provid AIDS Care. 2017 ; 16(5): 499–505. doi:10.1177/2325957417709089.
BMC Medicine201210:107
https://doi.org/10.1186/1741-7015-10-107© Katchanov and Birbeck; licensee BioMed Central Ltd. 2012
Received: 10 July 2012Accepted: 24 September 2012Published: 24 September 2012
In 2011, the World Health Organization’s
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(WHO) mental health Gap Action Programme (mhGAP) released evidence-based epilepsy-care guidelines for use in low and middle income countries (LAMICs). From a
geographical, sociocultural, and political perspective, LAMICs represent a heterogenous group with significant differences in the epidemiology, etiology, and perceptions of epilepsy. Successful implementation of
the guidelines requires local adaptation for use within individual countries. For effective implementation and sustainability, the sense of ownership and empowerment must be transferred from the global health authorities to the local people. Sociocultural and financial barriers that impede the implementation of the guidelines should be
identified and ameliorated. Impact assessment and program revisions should be planned and a budget allocated to them. If effectively implemented, as intended, at the primary-care level, the mhGAP
guidelines have the potential to facilitate a substantial reduction in the epilepsy treatment gap and improve the quality of epilepsy care in resource-limited settings.
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Framework for strengthening integration of mental health in programs
Catholic Relief Services; USAID; PEPFAR; 4 Children (Coordinating Comprehensive Care for Children); et al.
(2018)
C2
For children orphaned or made vulnerable by HIV (OVC)
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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Women and girls have specific needs that are often ignored during crisis. While on the run or while living in shelters, women and girls continue to become pregnant, but they often lack access to basic sexual and reproduc-tive health
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care. Without assistance by midwifes or access to contraceptives, women and girls are at increased risk of unsafe sex, unwanted pregnancy and unsafe delivery, and are at a higher risk of infection by HIV and other sexually transmitted infections. In addition, displaced women have virtually no access to protection, security, justice, and other services related to gender-based violence (GBV). For these reasons, the delivery of sexual and reproduc-tive health and rights (SRHR) as well as GBV services to conflict-affected communities – most of whom are living in protracted displacement – is a key part of UNFPA’s Women and Girls First Programme (WGF). The initia-tive is a commitment to prevent and respond to violence perpetrated against women and girls in Myanmar, and to realize their sexual and reproductive health and rights.
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For the purpose of this document, Interprofessional is defined as: Multiple health disciplines with diverse knowledge and skills who share an integrated set of goals and who utilize interdependent collaboration that involves communication, sharing o
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f knowledge and coordination of services to provide services to patients/clients and their care-giving systems. This best practice guideline, Developing and Sustaining Interprofessional Health Care: Optimizing patients/clients, organizational, and system outcomes is intended to foster healthy work environments. The focus in developing this guideline was identifying attributes of interprofessional care that will optimize quality outcomes for patients/clients, providers, teams, the organization and the system. This guideline identifies best practices to enable, enhance and sustain teamwork and interprofessional collaboration, and to enhance positive outcomes for patients/clients, systems and organizations. It is based on the best available evidence; where evidence was limited, the recommendations were based on the consensus of expert opinion.
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This field study to assess the pharmaceutical situation was undertaken in Ghana in May-June 2008 using a standardized methodology developed by the World Health Organization. The study assessed medicines availability and affor
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dability, geographical accessibility, quality and rational use among other issues. The survey was conducted in six regions. In each region, 6 public health care facilities, 12 private pharmacies and 1 warehouse were surveyed.
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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 avoidab
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le. As countries strive to
achieve universal 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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STANDARD OPERATING PROCEDURES
PARTICIPANT GUIDE
This Participant Guide has been designed to assist health facilities and community based non-clinicians to develop skills to provide linkage to care
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, adherence and retention in care services for chronic conditions
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Senegal private health sector assessment: Selected health products and services
Brunner B., J. Barnes, A. Carmona et. al.
United States Agency for International Development
(2016)
C2
SHOPS and HIA finalized a scope of work with USAID Senegal in April 2015, and a team of five private sector experts conducted the onsite assessments between May and June 2015. The Private Sector Assessment (PSA) team worked closely with Senegalese key stakeholders throughout the process. The PSA tea
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m interviewed more than120 individuals from approximately 78 organizations, including the government of Senegal (GOS), donors, USAID implementing partners, private sector umbrella organizations, private insurance companies, faith-based organizations (FBOs), nongovernmental organizations (NGOs), private health care facilities, and private pharmacies.
Through stakeholder interviews and review of government reports and online resources, the assessment team noted the following findings by theme.
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A case study of the role of an Essential Health Benefit in the delivery of integrated health services in Zambia
Luwabelwa, M.; Banda, P; Palale M.; Chama-Chiliba, C.
Regional Network for Equity in Health in east and southern Africa (EQUINET)
(2017)
C1
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. more
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. more
Accessed: 02.05.2020
These interim IPC recommendations for health settings have been developed through the contributions of many individuals and institutions, such as the Centers for Disease Control-Kenya; ITECH; US Agency for International Develop
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ment (USAID) Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program; and WHO that are committed to ensuring that the transmission of COVID-19 to HCWs and the public within the health care setting is limited. The Ministry of Health (MOH) through the Directorate of Health Standards Quality Assurance and Regulations wishes to thank all the contributing authors led by the sub-committee on case management and IPC for the COVID-19 response for their expertise and time given to writing these guidelines.
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Addressing gaps and improving health system performance is simply not enough to prepare a health system to tackle the effects of the climate crisis. Climate change’s impact on the
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health and well-being of people globally is reaching catastrophic levels. As the earth continues to warm, tens of millions of people are at increased risk from rapid and unpredictable spread of infectious diseases, heatwaves, water and food insecurity and scarcity, air pollution, poverty and homelessness. Health services are often regarded as a first line defense in preventing adverse health outcomes, especially from those caused by climate impacts
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The purpose of this workbook is to assist ministries of health, health managers and practitioners in engaging with the private sector on delivery of quality maternal, newborn and child
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health (MNCH) services in lower- and middle-income countries. Private health care is one of the fastest growing segments of the health-care system in lower- and middle-income countries, and private providers are an important source of health care. To accelerate progress to reach the Sustainable Development Goals for ending preventable maternal, newborn and child deaths, it is critical that whole health system organizations invest not only in increasing coverage of interventions, but also in quality. The audience for the workbook is those who are involved with organizing and implementing processes for engaging the private sector in delivery of quality MNCH services.
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Public Health Aspects of Mental Health Among Migrants and Refugees: A Review of the Evidence on Mental Health Care for Refugees, Asylum Seekers and Irregular Migrants in the WHO European Region
Priebe, S.; D. Giacco, and Rawda El-Nagib.
World Health Organization WHO; Regional Office Europe
(2016)
C_WHO
Health Evidence Network Synthesis Report, No. 47
The increasing number of refugees, asylum seekers and irregular migrants poses a challenge for mental health
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services in Europe. This review found that these groups are exposed to risk factors for mental disorders before, during and after migration. The prevalence rates of psychotic, mood and substance use disorders in these groups are variable but overall are similar to those in the host populations; however, the rates of post-traumatic stress disorder in refugees and asylum seekers are higher.
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The United Nations Population Fund (UNFPA) is the lead UN agency working to further gender equality and women’s empowerment in Sri Lanka. We are pleased to be a part of the joint effort with the Ministry of Health to develop the first ‘Standard
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Operating Procedures on sexual and gender-based violence for first-contact-point healthcare providers’.
These operating procedures were developed alongside the ‘National guidelines on sexual and gender-based violence’, which aims to strengthen Sri Lanka’s health systems response to survivors of violence. We are grateful to the British High Commission in Colombo for their support in developing these guidelines and procedures as they mark an important milestone in creating a safer Sri Lanka for all women and girls. UNFPA is proud to be a part of this journey, and we stand ready to provide continued assistance to the Government of Sri Lanka and all key stakeholders to ensure women and girls receive essential services that support their safety, well-being and access to justice and to create a violence-free Sri Lanka.
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and con
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trol (IPC) practices, and ensuring patient safety and quality of care. Such services are also essential for creating an environment that supports the dignity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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World Psychiatry. 2010 Jun;9(2):67-77.
The main recommendations are presented in relation to: the need for coordinated policies, plans and programmes, the requirement to scale up services for whole populations, the importance of promoting community
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awareness about mental illness to increase levels of help-seeking, the need to establish effective financial and budgetary provisions to directly support services provided in the community. The paper concludes by setting out a series of lessons learned from the accumulated practice of community mental health care to date worldwide, with a particular focus on the social and governmental measures that are required at the national level, the key steps to take in the organization of the local mental health system, lessons learned by professionals and practitioners, and how to most effectively harness the experience of users, families, and other advocates
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In 2020, the COVID-19 pandemic impacted the world beyond imagination. To date, it has infected more than 135 million people, killed over 2.9 million people, and is projected to plunge up to 115 million people into extreme poverty.1 As countries have gone into lockdown, gender-based violence has incr
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eased, unemployment has soared, and access to health care for the poorest and most vulnerable has been cut. COVID-19 has made people less likely to seek health care because they are afraid of getting infected with the virus. Fear and uncertainty surrounding COVID-19 have also increased stigma and discrimination. As frontline workers without enough access to personal protective equipment (PPE) risk their lives to treat patients, the virus pushes already fragile health systems to the brink.
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This document describes the key areas that national governments should consider for the introduction and scale-up of point-of-care (POC) diagnostics within national programmes, as new innovative POC technologies are being introduced into the market.
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The next steps taken to include these new innovations within the broader context of national diagnostic networks of conventional laboratories could influence the achievement of the 2030 Fast Track targets for ending the AIDS epidemic.
POC diagnostics, when strategically introduced and integrated into national diagnostic networks, may help catalyse changes that improve the way diagnostics and clinical services are delivered. This document distils this understanding based on programmatic and market experiences of introducing POC diagnostics through catalytic investments in POC HIV technologies across numerous countries in sub-Saharan Africa. more
POC diagnostics, when strategically introduced and integrated into national diagnostic networks, may help catalyse changes that improve the way diagnostics and clinical services are delivered. This document distils this understanding based on programmatic and market experiences of introducing POC diagnostics through catalytic investments in POC HIV technologies across numerous countries in sub-Saharan Africa. more
A handy desk reference tool for primary level health workers. The Adolescent Job Aid is a handy desk reference tool for health workers (trained and
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registered doctors, nurses and clinical officers) who provide services to children, adolescents and adults. It aims to help these health workers respond to their adolescent patients more effectively and with greater sensitivity. It provides precise, step-by-step guidance on how to deal with adolescents when they present with a problem or a concern about their health or development
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