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Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary ...-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primary health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
In this version of the compendium, each guidance is coded using the International Classification of Health Interventions (ICHI).
The compendium ...
Despite recent global declines, under-five mortality remains high in many of the poorest countries. Barriers to timely
quality care, including user fees, distance to facilities and the availabilit...
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...
This discussion guide is designed to assist individuals and
agencies working toward developing trauma-informed
approaches to service delivery. It describes how common
traumatic experiences are for individuals accessing ...
and social services, and it provides information to help service
providers recognize the adaptations people make to cope with
trauma. Trauma awareness is a foundation for developing
trauma-informed services, which integrate knowledge about
trauma into policies, procedures, and practices. Traumainformed
services actively seek to avoid re-traumatization and
have been shown to improve client engagement, retention, and
outcomes. This guide includes practice examples, suggested
resources, and sample questions to stimulate further discussion.
Introduction The novel Coronavirus (nCoV) epidemic in 2019 -2020 has recently emerged. The route of transmission is not totally known, although it is known that it can spread from person to person, and local ... care systems may be ill-equipped to handle a large-scale outbreak. Furthermore, misconceptions and misinformation about the disease often spreads rapidly in such epidemics.
In previous epidemics mental health and psychosocial support (MHPSS) has been identified as a key priority. MHPSS ensures the well-being of the affected populations, and counter-acts the threats to public health and safety that fear, stigmatization and misconception pose. Access to information, knowledge about the disease and how it spreads, make it easier for the affected to feel supported and calm, and to comply with instructions. Furthermore, psychosocial support to staff and volunteers help the operation as work conditions are extremely stressful.
This briefing note provides background knowledge on the MHPSS aspects related to nCoV and suggests MHPSS activities that can be implemented. The messages can be helpful for those in contact with patients or relatives and feel the strain of working and living during the epidemic. The briefing is aimed both at those working in any capacity with those affected by nCoV and for the MHPSS responders who implement MHPSS activities and interventions for everyone affected.
Mental disorders impose an enormous burden on society, accounting for almost one in three years lived with disability globally. •In addition to their health impact, mental disorders cause a significant economic burden due to lost economic output a...
The 2014-2015 outbreak of Ebola virus disease (EVD) in Liberia resulted in over 10,000 cases and 5,000 deaths. Recognizing the importance of addressing children’s trauma, the Ebola recovery and re...
14 January 2021
This practical guide can be used to help countries monitor and analyse the impact of COVID-19 on essential health services to inform planning and decision-making. It provides practi...
CHWs demonstrated social commitment and purpose in the short term observed. The evaluation of the training of CHWs revealed that most demonstrated the necessary skills for referrals to prevent compl...
This document, Programme and curriculum development guide, presents a systematic approach to developing programmes and curricula for implementation of the family planning (FP) and comprehensive abortion ca... (CAC) competencies,and the theory behind the approach. Specifically, the aim is for effective implementation of these competencies in the context of pre-service education and training, post-graduate studies and continuing professional development (CPD). This guide is designed for programme and curriculum developers who are preparing or revising formal education and training programmes and curricula for the FP and CAC workforce.
This guide proposes a new FP and CAC Educational Design Model for programme and curriculum development. This model can support competency-based education (CBE) for current and future FP and CAC services, with a pre-service training pathway of at least 12 months, and can also support in-service training. CBE provides the most effective means to orient educational programmes and curricula towards effective health services that meet population health needs, and this Educational Design Model provides a guide for linking the competencies required to provide a range of health services
Today, patient harm due to unsafe care is a large and growing global public health challenge and is one of the
leading causes ... death and disability worldwide. Most of this patient harm is avoidable. 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.
The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause ... death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a fra...
This version of Field Trials of Health Interventions includes seven new chapters on conducting systematic literature reviews, trial
governance, pr...
First Global Patient Safety Challenge Clean Care is Safer Care
The WHO Guidelines on Hand Hygiene in Health ... provide health-care workers (HCWs), hospital administrators and health authorities with a thorough review of evidence on hand hygiene in health care and specific recommendations to improve practices and reduce transmission of pathogenic microorganisms to patients and HCWs. The present Guidelines are intended to be implemented in any situation in which health care is delivered either to a patient or to a specific group in a population. Therefore, this concept applies to all settings where health care is permanently or occasionally performed, such as home care by birth attendants.
This article unites the latest guidelines on the management of arterial hypertension in primary health care in Portuguese speaking countries includ...
A focus on Cambodia and Ethiopia
o date, little evidence is available on how such integration occurs at country level. To address this knowledge gap, WHO has conducted several in-depth situational analysis in countries that are undertaking actions to improve WASH in ... Care Facilities as part of their quality of care improvement efforts. The purpose of the situation analyses was to capture mechanisms that “jointly support” WASH in HCF and quality of care improvements and also identify barriers and challenges to implementing and sustaining these improvements.
There is little doubt that 2019 was a defining year on many fronts for the environment. The repercussions of the climate emergency were experienced across the globe, with floods, devastating wildfires, and unprecedented melting ... polar ice sheets and glaciers. While the new decade began with the Australian bushfires still raging after the hottest and driest year on record, the world was soon (and still is) in the grip of the COVID-19 pandemic.
The toolkit provides guidance on where to get started, including the structures and resources that should be put in place at the national and health-care facility level, through a stepwise approach ...
