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[Preface]. For more than forty years Primary Health Care (PHC) has been recognized as the cornerstone of an effective and responsive health .... The Alma-Ata Declaration of 1978 reaffirmed the right to the highest attainable level of health, with equity, solidarity and the right to health as its core values. It stressed the need for comprehensive health services, not only curative but services that addressed needs in terms of health promotion, prevention, rehabilitation and treatment of common conditions. A strong resolutive first level of care is the basis for health system development [...] The Pan American Health Organization/World Health Organization (PAHO/WHO) has supported the countries in the establishment of interprofessional PHC teams, in the transformation of health education and in building capacity in the strategic planning, and management of human resources for health. Nursing can play a critical role in advancing PHC. New profiles such as the advanced practice nurses, as discussed in this document, can be fundamental in this effort, and in particular, in health promotion, disease prevention and care, especially in rural and underserved areas. more
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Childhood obesity is a major public health problem globally, which could undermine progress towards achieving the Sustainable Development Goals. Prevention is recognized as the most efficient means of curbing the epidemic; however, given the scale o... more
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According to the previous NHSSP 2014 - 2020, the long-term health sector objective is “the provision of adequate, effective and affordable health care... more
The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health ... more
Background: Primary health care (PHC) is a driving force for advancing towards universal health coverage (UHC). PHC-oriented ... systems bring enormous benefits but require substantial financial investments. Here, we aim to present measures for PHC investments and project the associated resource needs. Methods: This modelling study analysed data from 67 low-income and middle-income countries (LMICs). Recognising the variation in PHC services among countries, we propose three measures for PHC, with different scope for included interventions and system strengthening. Measure 1 is centred on public health interventions and outpatient care; measure 2 adds general inpatient care; and measure 3 further adds cross-sectoral activities. Cost components included in each measure were based on the Declaration of Astana, informed by work delineating PHC within health accounts, and finalised through an expert and country validation meeting. We extracted the subset of PHC costs for each measure from WHO’s Sustainable Development Goal (SDG) price tag for the 67 LMICs, and projected the associated health impact. Estimates of financial resource need, health workforce, and outpatient visits are presented as PHC investment guide posts for LMICs. more
Unpreparedness of health professionals to address non-communicable diseases (NCD) at peripheral health facilities is a critical health ... challenge 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. more
Internally displaced persons (IDPs), refugees, migrants and returnees constitute a sizeable population in the WHO Eastern Mediterranean Region. There were 12 million refugees (half are Palestinians) and 13 million IDPs in the Region as of 2018. These populations are often vul... more
Implementation guide for national, district and facility levels. This implementation guide contains practical guidance for policy-makers, programme managers, health practitioners and other actors working to establish and implement quality of ... (QoC) programmes for maternal, newborn and child health (MNCH) at national, district and facility levels. It is intended to help anyone, throughout the health system, who wants to take action to improve the QoC for MNCH. more
Obesity in all age groups, including children and adolescents, is a public health challenge across all settings. Obesity is now classified as a complex multifactorial chronic disease and not just a risk factor for other noncommunicable diseases and ... more
USAID funded/ Primary Health Care Project in Iraq (PHCPI) in cooperation with Iraqi Ministry of Health (MOH) aims to promote Primary ... Care (PHC) services provided by Primary Health Care Clinics (PHCCs) in Iraq in order to achieve the development goal in enhancing the PHC provision system through achieving the following results: First: Enhancing management and operations systems, which support clinical care. Second: Improving the quality of the delivered PHC according to quality standards. Third: Enhancing and expanding local community participation and partnership in PHC. Maintaining the medical & service devices in the hospitals and health clinics besides making them function according to the adapted standard specifications, lead to providing most efficient medical services for people and accomplish the purposes for which they were invented. Maintenance and repair of facilities and infrastructure, and keeping them safe and clean are also of the important approaches for the results referred to in (first) and (second) above. This can be achieved through enhancing and developing facilities, and medical & service devices management. This guideline seeks to develop work mechanism for engineers, technicians and the PHCCs’ facilities and medical & service equipment maintenance workers; clarify the concept of maintenance, its importance and classifications in health area, its planning and implementation, the tasks and duties of other directorates and departments of the Ministry in relation to all kinds of maintenance. Add to that preparing documents and forms, which are used in documenting and monitoring the steps required to be accomplished in the maintenance of PHCCs’ facilities and medical & service equipment, for the equipment to perform the best possible services for people and get their satisfaction. more
Health, safety and wellbeing of the Healthcare workers is a prerequisite for good quality of care and patient satisfaction in ... services. Healthcare facilities that are not safe for workers and patients are not resilient to any shock arising from hostile events, outbreaks or any other emergencies. Occupational Safety and Health Act (2005) and the National Occupational Safety and Health Policy of Zanzibar require the development of stringent systems for managing occupational safety and health in all workplaces and the health system in general. These Policy Guidelines have been developed by the Ministry of Health in consultation with the Ministry responsible for Labour and other stakeholders, such as organizations of workers, employers and professional associations in the health sector. The purpose of these guidelines is to foster the implementation of the international commitments and the national legislation regarding decent work in the health system as well as to improve the quality of care and the resilience of health facilities. more
28 days of war, 64 verified attacks on health care, and 18 million people affected. 24 March 2022; One month of war has had a devastating impact on Ukraine’s ... system, severely restricted access to services, and triggered an urgent need to treat trauma injuries and chronic conditions. Destroyed health infrastructure and disrupted chains of medical supplies now pose a grave threat to millions of people more
What are the FP and CAC competencies? Through the clear articulation of the family planning and comprehensive abortion care (FP and CAC) competencies for the primary health ... workforce, the aim is to advance improvements in FP and CAC service delivery by aligning health worker education approaches with population health needs and health system demands. This document, which describes these competencies in detail, is intended to: be a foundational tool to be adopted and adapted by educators and regulators for FP and CAC providers (students) with a pre-service training pathway of at least 12 months; describe competencies that are relevant to current and future health practice; enable widespread use of the competencies not only for curriculum development for pre-service education, but also for in-service education, regulation, qualifications, quality assurance, personal development, performance evaluation, recruitment, management and career progression; focus on the core functions of FP and CAC providers within broader efforts towards achieving universal health coverage more
Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the ... care system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how they view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system. 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 ... 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
This is a case-ascertained prospective investigation of all identified health care contacts working in a health ... facility in which a laboratory confirmed 2019-nCoV infected patient (see 2.2 Study population) receives care. Note that this study can be done in health care facilities at all 3 levels of a health system – not just in hospitals. It is intended to provide epidemiological and serologic information which will inform the identification of risk factors 2019-nCoV infection among health care workers. There are three primary objectives of this investigation among health care workers in a health care setting where a 2019-nCoV infected patient is being cared for: To better understand the extent of human-to-human transmission among health care workers, by estimating the secondary infection rate1 for health care worker contacts at an individual level. To characterize the range of clinical presentation of infection and the risk factors for infection among health care workers. To evaluate effectiveness of infection prevention and control measures among health care workers To evaluate effectiveness of infection prevention and control programmes at health facility and national level more
For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, incon... more