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Publication Years
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Toolboxes
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The objective of this project was to list the medical devices required to provide the essential reproductive, maternal, newborn and child health interventions defined by existing WHO guidelines and
...
publications, in order to improve access to these devices in low- and middle-income countries, support quality of care, and strengthen health-care system. The medical devices are allocated across the reproductive, maternal, newborn and child health continuum of care according to the level of health-care delivery.
more
Patient-centred care (PCC) is a pillar of quality health services, where decision-making power is shared between the clinician and the patient. Alt
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hough, this approach could be adopted with easiness in high income settings or in countries with unified health systems, in settings such as Peru, where universal access and other structural problems remain a challenge, the practice of PCC is not a priority. In Peru, research on PCC has been conducted for almost two decades, but this has not generated a need for development in academia, decision makers, health personnel or patients. Here, we give an overview of the road that PCC research has taken in Peru and the challenges that remain to translate it into clinical practice.
more
Countries must invest at least 1% more of GDP on primary health care to eliminate glaring coverage gaps
At current rates of progress up to 5 billion people will miss out on
...
health care in 2030
Countries must increase spending on primary healthcare by at least 1% of their gross domestic product (GDP) if the world is to close glaring coverage gaps and meet health targets agreed in 2015, says this new report. They must also intensify efforts to expand services countrywide.
The world will need to double health coverage between now and 2030, according to the Universal Health Coverage Monitoring Report. It warns that if current trends continue, up to 5 billion people will still be unable to access health care in 2030 – the deadline world leaders have set for achieving universal health coverage. Most of those people are poor and already disadvantaged.
more
The availability of water, sanitation and hygiene (WASH) services in health care facilities, especially in maternity and primary-
...
care settings where they are often absent, supports core aspects of quality, equity and dignity for all people. This document describes an approach for conducting a national situational analysis of water, sanitation and hygiene (WASH) as a basis for improving quality of care. This document describes the process from the initial preparatory stages, including triggers for action, through data collection and analysis to the dissemination of results. Each element of the approach is described and possible limitations and mechanisms to mitigate these are explored.
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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
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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 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.
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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 system.
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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.
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Bull World Health Organ 2020;98:773–780
Universal health coverage (UHC) depends on a strong primary health-
...
care
system. To be successful, primary health care must be expanded at community and household levels as much of the world’s population still lacks access to health facilities for basic services. Abundant evidence shows that community-based interventions are effective for improving health-care utilization and outcomes when integrated with facility-based services. Community involvement is the cornerstone of local, equitable and integrated primary health care.
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The WHO Quality Health Services: a planning guide focuses on actions required at the national, district and facility levels to enhance quality of health
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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.
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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
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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.
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A Training Curriculum for Multidisciplinary Healthcare Teams. This innovative training package aims to empower multidisciplinary health workers to have the confidence and skills to provide comprehensive, youth-friendly HIV
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services that support adolescents’ healthy development, psychosocial well being, retention, adherence, sexual and reproductive health, and eventual transition to adult HIV services.
more
Essential obstetric and newborn care
recommended
Essential obstetric and newborn care is designed as a tool to help protect mothers and their children in adverse environments. It is intended for midwives, doctors with obstetrics training, and
...
health care personnel who deal with obstetric emergencies.
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
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. 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.
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It summarizes guidance on how to manage – and when to refer – children and adolescents presenting with common complaints and conditions. It includes information to enable primary health care pro
...
viders to coordinate the continued care of children and adolescents with long-term conditions and diseases managed by specialists. Preventive and promotive measures from the newborn period to adolescence include advice on the timing and content of well-child visits, the promotion of early childhood development and health messages for adolescents.
This Pocket Book aims to improve the diagnosis and management of common conditions in children and adolescents that can be managed at the outpatient level. It helps to improve the use of laboratory and other diagnostic measures and the rational use of essential drugs and equipment.
more
The role of an essential health benefit in health systems in east and southern Africa: Learning from regional research
R. Loewenson, M. Mamdani and others
Regional Network for Equity in Health in east and southern Africa (EQUINET)
(2018)
C1
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 113
This report synthesises the learning across the full programme of work. It presents the methods used, the context and policy motivations for deve ... loping EHBs; how they are being defined, costed, disseminated and used in health systems, including for service provision and quality, resourcing and purchasing services and monitoring and accountability on service delivery and performance, and for learning, useful practice and challenges faced. more
This report synthesises the learning across the full programme of work. It presents the methods used, the context and policy motivations for deve ... loping EHBs; how they are being defined, costed, disseminated and used in health systems, including for service provision and quality, resourcing and purchasing services and monitoring and accountability on service delivery and performance, and for learning, useful practice and challenges faced. 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
...
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
more
RESULTS: Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the
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services during the lockdown and up to 10% decline after the lockdown with variation across and within States. During the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients' utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19.
CONCLUSIONS: The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.
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
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comorbidities. Recognizing the significance of primary health care for an effective and efficient response to the obesity epidemic, the World Health Organization (WHO) has developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach.
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This document sets out the preparedness and response plan of the Nigerian Primary Health Care System for COVID-19 Acute Respiratory Disease. It outlines the planning scenarios, key areas of work and
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priority activities required for the Primary Health Care Sector to quickly scale up its core capacity to prevent, quickly detect, characterize and efficiently respond, in a coordinated manner to the COVID-19 pandemic. These include guidelines for the setup and operationalization of COVID-19 response platforms at the national and state levels, guidelines for the provision of PHC services during the pandemic to minimize transmission in PHCs as well as guidelines for preparedness and response of PHC Centres and communities for COVID-19 case detection and response.
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Int. J. Environ. Res. Public Health 2020, 17(23), 8849; https://doi.org/10.3390/ijerph17238849
The aim of building climate resilient and environmentally sustainable health
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care facilities is: (a) to enhance their capacity to protect and improve the health of their target communities in an unstable and changing climate; and (b) to empower them to optimize the use of resources and minimize the release of pollutants and waste into the environment. Such 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 an important component of universal health coverage.
more
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
