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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 systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar
...
y 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
Contact tracing is a key element of WHO’s recommended approach to control the spread of COVID-19 by breaking the chains of human-to-human transmission.
This document provides guidance to health authorities at all levels to improve the success rat
...
e of contact tracing by informing efforts with RCCE principles, evidence and activities, and provides ready-to-use tools for professionals involved in contact-tracing efforts to inform their practices with RCCE principles and likewise improve their success rate.
more
In 2016 CRS leveraged the robust infrastructure of its large, multi-sectoral orphans and vulnerable children (OVC) program in Nigeria by expanding the program's core mandate to include community childhood TB casefinding, with a focus on highly vulne
...
rable children and their caregivers
more
Sexual and gender-based violence (SGBV) threatens displaced women and girls, as well as men and boys, in all regions of the world. Creating safe environments and mitigating the risk of SGBV can only be achieved by addressing gender inequality and discrimination. While the scourge of SGBV is receivin
...
g much more attention internationally – as illustrated by Security Council Resolutions 1820, 1888 and 1960 – preventing SGBV is a complex challenge. To assist operations in addressing this core protection concern, UNHCR is presenting the Action against Sexual- and Gender-Based Violence: An Updated Strategy. This strategy provides a structure to assist UNHCR operations in dealing with SGBV on the basis of a multi-sectoral and interagency approach. UNHCR policies and programmes have for many years helped operations to address SGBV in coordination with other actors. 80% of operations in urban settings and 93% in camp settings work with SGBV Standard Operating Procedures which strengthen cooperation between partners. Moreover, support to community-based organisations has given communities a greater sense of ownership in addressing SGBV.
more
Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary care systems can include team-based care strategies in their clinic workflows and protocols. Team-based care uses multidisciplinary teams (wh
...
ich may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
more
The CHW Toolkit assists the assessment, improvement, and planning of CHW programs by deepening understanding of the elements of successful programs and the use of best practices as an evidence-based approach to improvement. The toolkit is framed aro
...
und ten key themes that describe the definition, entry level, age, gender, recruitment, training, scope of work, supervision, career progression, entry level and remuneration of CHWs.
more
Community Engagement During Public Health Emergencies Like COVID-19: An Action Framework and Toolkit
This handbook offers a simple framework of action for actors in local government, and in particular, health leaders such as Civil Surgeons (CSs) and Upazila Health and Family Planning Officers (UHFPQOs), to take ownership and leadership to combat COVID-19 at each district and upazila respectively, w
...
ith support and guidance from elected representatives and local administration, and through effective engagement of various segments of society including informal health care providers, religious leaders, journalists, police and law enforcement agencies, etc. The toolkit draws extensively from the experiences in Chapainawabganj, Savar and other areas and contains relevant best practises that have already proven effective in these places, which should be readily adaptable to various contexts.
It is important to note that while this framework has been developed in the context of COVID-19 and with related best practises, it is by no means limited to COVID-19 response. Indeed, the experience from Savar shows that the same approach has proven extremely effective in combating the dengue outbreak and the severe floods in 2020, and hence can be used to combat future public health emergencies in Bangladesh and other countries having similar contexts.
more
This document provides guidance on the implementation of the shielding approach in camps and camp-like settings for refugees and internally displaced persons. It is intended for the displaced
...
community itself, humanitarian actors and camp coordination / management authorities.
more
Psychological first aid for schools: Field operations guide, 2nd Edition
Brymer M., Taylor M., Escudero P., Jacobs A., Kronenberg M., Macy R., Mock L., Payne L., Pynoos R., & Vogel J.
National Child Traumatic Stress Network (NCTSN) & National Center for PTSD
(2012)
C2
National Child Traumatic Stress Network National Center for PTSD | The field of school safety and emergency management has evolved significantly over the past decade. Tragically, acts of violence, natural disasters, and terrorist attacks have taught us many lessons. We also know that other types of
...
emergencies can impact schools, including medical emergencies, transportation accidents, sports injuries, peer victimization, public health emergencies, and the sudden death of a member of the school community. We now recognize the need for school emergency management plans that are up-to-date and take an “all-hazards” approach with clear communication channels and procedures that effectively reunite parents and caregivers with students. We have also learned that preparing school administrators, teachers, and school partnering agencies before a critical event is crucial for effective response, the value of ongoing training and emergency exercises, and that having intervention models that address the public health, mental health, and psychosocial needs of students and staff is essential to a safe school environment and the resumption of learning.
more
UNICEF: Protecting Ourselves from Cholera
recommended
This flipchart is a visual support for community workers, health workers, emergency workers, and in general all staff conducting face-to-face communication in response to a cholera outbreak.
How to use it?
The flipchart is intended as a suppor
...
t for animating individual or group discussions on life-saving practices.
To facilitate involvement of communities for an effective response to the outbreak, this flipchart should be used to provide information and stimulate discussion, rather than to “pass messages”.
An integrated communication approach
The flipchart should not be used alone; effective communication strategy involves the use of a variety of channels and actors. It will be critical to integrate face-to-face discussion with other channels such as local radios, schools, mosques, churches, etc., and to associate different actors such as technical experts, community representatives and opinion leaders to animate them.
In emergency context it is critical not only to stimulate discussion but also to create mechanisms for interaction between communities and service providers such as regular meetings, participation to radio broadcasts or visits by community representatives to health posts; these mechanisms need to be carefully catered for with appropriate planning and resources.
more
The article explores the underlying factors influencing unhealthy diets and sedentary lifestyles among adolescents in Kilifi County, Kenya. Using a qualitative approach, the study involved interviews and focus group discussions with adolescents, sta
...
keholders, and young adults. Key findings include a preference for unhealthy, carbohydrate-rich, and sugary foods over traditional and nutritious options, exacerbated by factors like low socioeconomic status, urbanization, and poor farming practices.
Sedentary behavior, such as gambling and extensive technology use, was prevalent, often replacing physical activity. Protective factors like school attendance, community-based services, and parental engagement were identified as mitigating risks. The study highlights the importance of ecological intervention strategies targeting intrapersonal, interpersonal, and community factors to address unhealthy behaviors and promote better health outcomes in adolescents.
more
This toolkit is a comprehensive set of practical tools and resources designed to support country-level risk communication and community engagement (RCCE) practitioners, decision-makers, and partners to plan and implement readiness and response activ
...
ities for dengue fever outbreaks. The toolkit contains: information about dengue fever; RCCE considerations for how to approach key issues during dengue fever outbreaks; tools for understanding the context in which dengue fever outbreaks occur; methods for collecting data to inform strategy development and bring evidence into planning and implementation of activities; guidance to support vector control and prevention activities; case studies; and links to existing RCCE tools and training. It is one of a suite of toolkits on RCCE readiness and response to a range of disease and response areas.
more
An evidence-informed approach for non-formal, out-of-school CSE programmes that aims to reach young people from left-behind populations
This guidance is intended to assist anyone designing and/or implementing CSE in out-of-school settings, especial
...
ly in low- and middle-income countries. This includes international and national civil-society organizations, community-based organizations, government departments, UN agencies, health authorities, non-formal education authorities and youth development authorities. It is also intended for anyone else involved in the design, delivery and evaluation of sexuality education programmes out of school, especially those working with the specific groups of young people addressed in the guidance.
more
Essential health care service disruption due to COVID-19: lessons for sustainability in Nigeria
AHOP National Centre based in Nigeria
World Health Organization WHO, Regional Office Africa
(2022)
C_WHO
The brief concludes that sustaining the continuity of EHS requires policies that ensure a whole-society and systems strengthening approach. This involves increased health care investment, community
...
engagement, disease control regulations, and multisector approaches to improve resilience, EHS quality, and equity.
more
The Infection prevention and control in the context of coronavirus disease 2019 (COVID-19): a living guideline consolidates technical guidance developed and published during the COVID-19 pandemic into evidence-informed recommendations for infection prevention and control (IPC). This living guideline
...
is available both online and PDF.
**This version of the living guideline (version 5.0) **includes the following seven revised statements for the prevention, identification and management of SARS-CoV-2 infections among health and care workers:
a good practice statement on national and subnational testing strategies;
a good practice statement on passive syndromic surveillance of health and care workers;
a good practice statement on prioritizing health and care workers for SARS-CoV-2 testing;
a good practice statement on protocols for reporting and managing health and care worker exposures;
a good practice statement to limit in-person work of health and care workers with active SARS-CoV-2 infections;
a statement on high-risk exposures and quarantine; and,
a conditional recommendation on the duration of isolation for health and care workers.
Understanding the updated section
Prevention of infections in the health care setting includes a multi-pronged and multi-factorial approach that includes IPC and occupational health and safety measures and adherence to Public Health and Social Measures in the community by the health workforce. The underlying infection prevention and control strategy of this section is the notion that early identification of symptomatic cases, testing and quarantining/isolating health and care workers decreases the risk of nosocomial infection to patients and to other health and care workers.
more
Information and Advice for the Home: COVID-19 at home
recommended
Knowledge Translation Unit, University of Cape Town Lung Institute
Western Cape Department of Health
(2021)
CC
Updated May 2021. Manual 2. The Practical Approach to Care Kit – PACK – is used by nurses, doctors and community health workers in their everyday work to care for patients at the clinic and in t
...
he community –PACK Adult, PACK Adolescent, PACK Child and PACK Community.PACK Home is designed for people seeking more information about how to care for their own health and the health of their family at home.Collect and read all the PACK Home volumes in English, Afrikaans, isiXhosa, isiZulu or Sesotho
Download the different languages: https://knowledgetranslation.co.za/pack/pack-home/
more
Manual for step-by-step risk management for safely managed sanitation systems. 2nd edition.
This Sanitation safety planning (SSP) manual provides practical, step-by-step guidance to assist in the implementation of the 2018 World Health Organization (WHO) Guidelines on sanitation and health and the
...
2006 WHO Guidelines for safe use of wastewater, excreta and greywater in agriculture and aquaculture. The approach and tools should be applied to all sanitary systems to ensure that they are managed to meet health objectives.
The SSP manual is targeted at a variety of users at different levels including; health authorities and regulators, local authorities, sanitation utility managers, sanitation enterprises and farmers, community-based organizations, farmers associations and nongovernmental organizations.
more
Information and Advice for the Home: Be coronavirus safe
recommended
Knowledge Translation Unit, University of Cape Town Lung Institute
Western Cape Department of Health
(2021)
CC
Manual 1. The Practical Approach to Care Kit – PACK – is used by nurses, doctors and community health workers in their everyday work to care for patients at the clinic and in the
...
community –PACK Adult, PACK Adolescent, PACK Child and PACK Community.PACK Home is designed for people seeking more information about how to care for their own health and the health of their family at home.Collect and read all the PACK Home volumes in English, Afrikaans, isiXhosa, isiZulu or Sesotho
Download the different languages: https://knowledgetranslation.co.za/pack/pack-home/
more
Information and Advice for the Home: Chronic conditions at home
recommended
Knowledge Translation Unit, University of Cape Town Lung Institute
Western Cape Department of Health
(2021)
CC
Updated May 2021. Manual 3. The Practical Approach to Care Kit – PACK – is used by nurses, doctors and community health workers in their everyday work to care for patients at the clinic and in t
...
he community –PACK Adult, PACK Adolescent, PACK Child and PACK Community.PACK Home is designed for people seeking more information about how to care for their own health and the health of their family at home.Collect and read all the PACK Home volumes in English, Afrikaans, isiXhosa, isiZulu or Sesotho
Download the different languages: https://knowledgetranslation.co.za/pack/pack-home/
more
Information and Advice for the Home: Be coronavirus safe at school
recommended
Knowledge Translation Unit, University of Cape Town Lung Institute
Western Cape Department of Health
(2021)
CC
Updated May 2021. Manual 4. The Practical Approach to Care Kit – PACK – is used by nurses, doctors and community health workers in their everyday work to care for patients at the clinic and in t
...
he community –PACK Adult, PACK Adolescent, PACK Child and PACK Community.PACK Home is designed for people seeking more information about how to care for their own health and the health of their family at home.Collect and read all the PACK Home volumes in English, Afrikaans, isiXhosa, isiZulu or Sesotho
Download the different languages: https://knowledgetranslation.co.za/pack/pack-home/
more
