Primary health care, as outlined in the 1978 Declaration of Alma-Ata and again 40 years later in the 2018 WHO/UNICEF document A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals, is a whole-of-government and whole-of-society a...pproach to health that combines the following three components: multisectoral policy and action; empowered people and communities; and primary care and essential public health functions as the core of integrated health services.(1) Primary health care-oriented health systems are health systems organized and operated so as to make the right to the highest attainable level of health the main goal, while maximizing equity and solidarity. They are composed of a core set of structural and functional elements that support achieving universal coverage and access to services that are acceptable to the population and that are equity enhancing. The term “primary care” refers to a key process in the health system that supports first-contact, accessible, continued, comprehensive and coordinated patient-focused care.
more
As the global community aims to fulfill its commitments to the UN Sustainable Development Goals, and the achievement of universal health coverage, dozens of countries have committed to the expansion of community health workers (CHWs) as the front line of their healthcare ...ghlight medbox">systems [1, 2]. Robust research demonstrates CHWs improve access to care, reduce maternal, newborn, and child mortality, improve clinical outcomes for chronic diseases, and prevent disease outbreaks [3].
To support the operationalization of quality CHW program design and implementation, USAID, UNICEF, the Community Health Impact Coalition, and Initiatives Inc. have updated and adapted the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Program Functionality Matrix [12]. This tool can be used to identify design and implementation gaps in both small- and national-scale CHW programs, and close gaps in policy and practice.
more
Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work they do. However, few have examined their experience...s 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
Implementation of the CHWs guidelines using Amref Health Africa lessons learnt
focuses on providing CHWs with predictable financial and non financial incentives,
frequent support supervision, continuous training and embedding them in health
systems...n> with clear roles.
Empowering CHWs represents a cost effective approach with a critical change to-
wards achieving universal health coverage.
more
Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community health workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in... community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
more
This National Health Policy has 5 objectives, namely
i. To strengthen the healthcare delivery system to be resilient
ii. To encourage the adoption of healthy lifestyles
iii. To improve the physical environment
iv. To improve the socio-economic s...tatus of the population
v. To ensure sustainable financing for health
These objectives shall collectively ensure that there will be improved alignment, complementarity and synergies within and across all public sector ministries as well as with other stakeholders, towards achieving the national health goal.
The policy shall therefore ensure that MDAs and other identifiable organizations work within the principles of the Health-in-All Policy and the One-Health Policy frameworks (WHO), to achieve the desired healthy life status of people living in Ghana.
more
This Cardiac Rehabilitation Change Package was completed by the Centers for Disease Control and Prevention (CDC) in collaboration with the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) with the purpose of helping cardiac rehabilitation programs, hospital quality improv...ement teams, and public health professionals who partner with these groups to implement systems and strategies that improve care for patients who are eligible for cardiac rehabilitation. AACVPR is a multidisciplinary professional association comprised of health professionals who serve in the field of cardiac and pulmonary rehabilitation.
more
Community health workers (CHWs) play a vital role in health service delivery, especially in countries with less resilient health systems. During any outbreak CHWs are relied on to help control the spread. However, they are often the last in line to ...receive necessary health products and protective equipment, which affects their ability to safely serve their communities.
more
USAID funded/ Primary Health Care Project in Iraq (PHCPI) in cooperation with Iraqi Ministry of Health (MOH) aims to promote Primary Health Care (PHC) services provided by Primary Health Care Clinics (PHCCs) in Iraq in order to achieve the development goal in enhancing the PHC provision ..."attribute-to-highlight medbox">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
This instructional video from the World Health Organization explains the evidence-based core components of infection prevention and control programmes, critical at both the national and acute health care facility level for patient safety and for health sys...tems to provide quality care. This video is brought to life by interviews from people in the field across a range of countries and describes the importance of the eight core components one by one. It will be a great addition to health care training sessions and the information is a key part of the infection prevention and control implementation and improvement process.
more
Background Unrest in Chile over inequalities has underscored the need to improve public hospitals. Nursing has been overlooked as a solution to quality and access concerns, and nurse staffing is poor by international standards. Using Chile’s new diagnosis-related groups ...ighlight medbox">system and surveys of nurses and patients, we provide information to policy makers on feasibility, net costs, and estimated improved outcomes associated with increasing nursing resources in public hospitals.
more
Welcome to the Infection Prevention and Control (IPC) training package. IPC is a major challenge for health care systems around the world and there is a significant opportunity to reduce avoidable morbidity and mortality through improvements to IPC.... Health care-associated infections (HAIs) and antimicrobial resistance (AMR) can be significantly reduced through effective IPC. The guidelines cover a range of topics including the core components of IPC programmes, hand hygiene, and the prevention of surgical site infection.
more
This rapid review report has identified the wastewater treatment plant (WWTP) options used in emergency settings, with decentralised wastewater treatment systems (DEWATS) and mobile wastewater treatment units performing most effectively and with min...imal costs. Examples are taken from refugee camps and internally displaced people (IDP) settlements due to the Iraq war, the Israeli-Palestine conflict, and the civil wars in Syria and Sudan. WWTP options used in Finland, Haiti, Iraq, Jordan, Palestine, Sudan and Turkey are discussed. Lessons learned from China and suggestions for the Rohingya crisis are also included.
more
UNHCR’s Public Health Strategy 2021-2025 is based on the lessons learnt, and builds on the achievements, of the Global Strategy for Public Health 2014-2018.
Progress was made on policies favouring inclusion and integration into national systems3 ...with 92% of 48 operations surveyed reporting refugees having access to national primary health care facilities under the same conditions as nationals and 96% reporting refugees having access to all relevant vaccines under the same conditions as nationals. While many refugee hosting countries have policies that allow refugees to access national health services, many face partial access, prohibitive out-of-pocket expenditures and other barriers including distance to facilities, language and provider acceptance. Furthermore, more work is needed on strengthening these systems to be able to meet the needs of both host communities and refugees.
more
Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
more
Every country has been affected by COVID-19, with nearly a quarter
of a billion cases and almost 5 million deaths reported globally as of
end of September 2021. Despite the stunning speed with which highly
effective and safe vaccines have been developed, new waves of disease
are still pushin...g health systems to the breaking point, increasingly
transmissible variants are emerging, some survivors are suffering
serious long-term sequelae, and the International Monetary Fund
estimates that global economic losses could exceed US$5.3 trillion
by 2026, if COVID-19 becomes endemic.
Although over 6 billion doses of COVID-19 vaccine have already been
administered, and global production is now reaching 1.5 billion doses
per month, the world is not positioned to end the pandemic. In areas of
high vaccine coverage, there have been massive reductions in serious
disease, hospitalization and death but, globally, vaccine access is highly
inequitable with coverage ranging from 1% to over 70%, depending
largely on a country’s wealth. Consequently, SARS CoV-2 variants
continue to emerge, causing surges of disease and slowing or even
reversing the reopening of societies and economies.
more
Healthy people, healthy animals and a healthy environment worldwide with the One Health approach.
The COVID-19 pandemic has drastically demonstrated just how close the link is between humans, animals, and the environment, and has highlighted and aggravated existing challenges. The destruction of na...tural habitats and displacement of species, trade in wild animals, resource-intensive lifestyles and conditions, non-sustainable food systems and, in particular, industrial agriculture and intensive livestock farming are the causes of the emergence of zoonoses as well as numerous other communicable and non-communicable, chronic diseases.
The One Health approach focuses precisely on such interaction between humans, animals, and the environment.
more
At a time when the world is reeling from the deepest global disruption and health crisis of a lifetime, this year’s Living Planet
report provides unequivocal and alarming evidence that nature is unraveling and that our planet is flashing red warning signs of
vital natural ...e-to-highlight medbox">systems failure. The Living Planet Report 2020 clearly outlines how humanity’s increasing destruction of nature is having
catastrophic impacts not only on wildlife populations but also on human health and all aspects of our lives.
more
Phil. Trans. R. Soc. B (2010) 365, 2959–2971; doi:10.1098/rstb.2010.0143.
Agricultural ecosystems provide humans with food, forage, bioenergy and pharmaceuticals and are essential to human wellbeing. These systems rely on ecosystem services provi...ded by natural ecosystems, including pollination, biological pest control, maintenance of soil structure and fertility, nutrient cycling and hydrological services. Preliminary assessments indicate that the value of these ecosystem services to agriculture is enormous and often underappreciated. Agroecosystems also produce a variety of ecosystem services, such as regulation of soil and water quality, carbon sequestration, support for biodiversity and cultural services. Depending on management practices, agriculture can also be the source of numerous disservices, including loss of wildlife habitat, nutrient runoff, sedimentation of waterways, greenhouse gas emissions, and pesticide poisoning of humans and non-target species. The tradeoffs that may occur between provisioning services and other ecosystem services and disservices should be evaluated in terms of spatial scale, temporal scale and reversibility. As more effective methods for valuing ecosystem services become available, the potential for ‘win–win’ scenarios increases. Under all scenarios, appropriate agricultural management practices are critical to realizing the benefits of ecosystem services and reducing disservices from agricultural activities.
more
High prices, hard-to-access human insulin, few insulin producers, and weak health systems are just some of the barriers that people with diabetes face a century after insulin was discovered, WHO notes in a new report