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220
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Category
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Toolboxes
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1
The key aim of this guideline is to present recommendations based on a critical evaluation of the evidence on emerging digital health interventions that are contributing to health system improvemen
...
ts, based on an assessment of the benefits, harms, acceptability, feasibility, resource use and equity considerations.
This guideline urges readers to recognize that digital health interventions are not a substitute for functioning health systems, and that there are significant limitations to what digital health is able to address
more
An estimated 1.3 billion people – or 16% of global population worldwide – experience a significant disability today. Persons with disabilities have the right to the highest attainable standard of health as those without disabilities. However, th
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e WHO Global report on health equity for persons with disabilities demonstrates that while some progress has been made in recent years, the world is still far from realizing this right for many persons with disabilities who continue to die earlier, have poorer health, and experience more limitations in everyday functioning than others. These poor health outcomes are due to unfair conditions faced by persons with disabilities in all facets of life, including in the health system itself. Countries have an obligation under international human rights law to address the health inequities faced by persons with disabilities. Furthermore, the Sustainable Development Goals and global health priorities will not progress without ensuring health for all.
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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
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health coverage and the Sustainable Development Goals, is a whole-of-government and whole-of-society approach 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.
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Unmet mental health needs in the Region of the Americas are a leading source of morbidity and mortality, which result in tremendous health, social, and economic consequences. The COVID-19 pandemic h
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as exacerbated the mental health crisis in the Region, necessitating urgent action at the highest levels of government and across sectors to build back better mental health now and for the future. This landmark report is the result of the PAHO High-Level Commission on Mental Health and COVID-19. It provides an analysis of the mental health situation in the Region, followed by a series of recommendations and corresponding actions to support countries in the Americas to prioritize and advance mental health using human rights- and equity-based approaches.
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An estimated 1.3 billion people globally experience significant disability. This figure has grown over the last decade and will continue to rise due to demographic and epidemiological changes. In 2022, the World Health Organization launched the Glob
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al report on health equity for persons with disabilities. This report demonstrated that many persons with disabilities are still being left behind. Experiencing persistent health inequities, persons with disabilities die earlier, they have poorer health and functioning, and they are more affected by health emergencies than the general population. These differences are largely associated with unjust factors both inside and beyond the health sector and are avoidable. The Global Report called upon Member States to take actions to make health sector more inclusive for persons with disabilities through the primary health care approach. This will be essential for countries to make health coverage truly universal and to progress towards other health-related targets in the sustainable development goals.
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The 10 recommendations in the COP26 Special Report on Climate Change and Health propose a set of priority actions from the global health community to governments and policy makers, calling on them t
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o act with urgency on the current climate and health crises.
The recommendations were developed in consultation with over 150 organizations and 400 experts and health professionals. They are intended to inform governments and other stakeholders ahead of the 26th Conference of the Parties (COP26) of the United Nations Framework Convention on Climate Change (UNFCCC) and to highlight various opportunities for governments to prioritize health and equity in the international climate movement and sustainable development agenda. Each recommendation comes with a selection of resources and case studies to help inspire and guide policymakers and practitioners in implementing the suggested solutions
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This 400 page guide, created by PHI’s Center for Climate Change and Health and the American Public Health Association (APHA), with support from the California Department of Public
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Health helps local health departments prepare for and mitigate climate change effects—from drought and heat to flooding and food security—with concrete, implementable suggestions.
The guide: Provides a basic summary of climate change and climate impacts on health; Prioritizes health equity, explains the disproportionate impacts of climate change on vulnerable communities, and targets solutions first to the communities where they are most needed, including low-income, elderly and people of color communities; Connects what we know about climate impacts and climate solutions with the work of local health departments; and Offers specific examples of how local health departments can address and ameliorate the impacts of climate change in every area of public health practice.
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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 method ... s used, the context and policy motivations for developing 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 method ... s used, the context and policy motivations for developing 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
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 110
This report compiles evidence from published, grey literature and key informants on the UNMHCP ... since its introduction in Uganda’s health system, and findings were further validated during a oneday national stakeholder meeting.
Three main factors motivated introduction of the UNMHCP. First, Uganda, along with other lowincome countries, was unable to implement holistically the primary healthcare (PHC) concepts as set out in the Alma Ata Declaration. Second, the macro-economic restructuring carried out in the 1990s, which was an international conditionality for low-income countries to access development financing, influenced the trend towards more stringent prioritisation of health interventions as a means of rationing and targeting use of resources. Third, the government sought to achieve equity with a service package that would be universally available for all people. more
This report compiles evidence from published, grey literature and key informants on the UNMHCP ... since its introduction in Uganda’s health system, and findings were further validated during a oneday national stakeholder meeting.
Three main factors motivated introduction of the UNMHCP. First, Uganda, along with other lowincome countries, was unable to implement holistically the primary healthcare (PHC) concepts as set out in the Alma Ata Declaration. Second, the macro-economic restructuring carried out in the 1990s, which was an international conditionality for low-income countries to access development financing, influenced the trend towards more stringent prioritisation of health interventions as a means of rationing and targeting use of resources. Third, the government sought to achieve equity with a service package that would be universally available for all people. more
The Ministry of Health has developed the first version of the Service Standards and Service Delivery Standards for the health sector in Uganda. The main objective is to provide a common understandin
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g of what is expected by the public, service users and service providers in ensuring provision of consistently high quality service delivery. These standards also provide a roadmap for improving the quality, safety and reliability of healthcare in Uganda.
The application of these standards is expected to improve transparency and accountability in service delivery; fairness and equity in service provision; building a culture of quality management; regulation, management and control of public and private providers; and management of expectations of service recipients. more
The application of these standards is expected to improve transparency and accountability in service delivery; fairness and equity in service provision; building a culture of quality management; regulation, management and control of public and private providers; and management of expectations of service recipients. more
Future of Nursing 2020-2030
Wakefield, M.K.; et al.
National Academy of Medicine; National Academies of Sciences, Engineering, and Medicine
(2021)
C1
Charting a Path to Achieve Health Equity. The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of
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health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions.
Free download available, register for free
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Under the theme Equity at the Heart of Health, this Plan seeks to catalyze efforts in Member States to reduce inequities in health within and betwe
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en countries and territories in order to improve health outcomes. The Plan identifies specific actions to tackle health inequality, including those recommended by the Commission on Equity and Health Inequalities in the Americas, with guidance from the High-level Commission for Universal Health. Four cross-cutting themes are central to this Plan’s approach to addressing the determinants of health: equity, gender, ethnicity, and human rights
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A case study of the role of an Essential Health Benefit in the delivery of integrated health services in Zambia
Luwabelwa, M.; Banda, P; Palale M.; Chama-Chiliba, C.
Regional Network for Equity in Health in east and southern Africa (EQUINET)
(2017)
C1
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia ... is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at district and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole. more
The health services delivery system in Zambia ... is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at district and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole. more
The National Strategic Plan is based on the following guiding principles:
1) Life-course approach: adolescence is a key decade in the course of life that influences the health outcomes later in life.
2) Comprehensive approach: It recogniz ... es the cross cutting health and development needs of young people such as intentional and unintentional injuries and violence, SRH, HIV/AIDS, mental health, substance use, violence, substance use and substance use disorders, infectious diseases and common conditions.
3) Equity and rights-based approach: focusing on equitable access to services to all adolescents including vulnerable groups and the recognizing the need to move from aspirations to obligations in fulflling young people rights for the highest attainable standard of health.
4) Multisectoral approach: recognizing cognizant of the fact that holistic development of young people requires multisectoral approach involving education, social welfare. more
1) Life-course approach: adolescence is a key decade in the course of life that influences the health outcomes later in life.
2) Comprehensive approach: It recogniz ... es the cross cutting health and development needs of young people such as intentional and unintentional injuries and violence, SRH, HIV/AIDS, mental health, substance use, violence, substance use and substance use disorders, infectious diseases and common conditions.
3) Equity and rights-based approach: focusing on equitable access to services to all adolescents including vulnerable groups and the recognizing the need to move from aspirations to obligations in fulflling young people rights for the highest attainable standard of health.
4) Multisectoral approach: recognizing cognizant of the fact that holistic development of young people requires multisectoral approach involving education, social welfare. more
As countries aim to progress towards the Sustainable Development Goals (SDGs) and achieving universal health coverage, health inequities driven by racial discrimination and intersecting factors rema
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in pervasive. Inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities are of concern globally; they are unjust, preventable and remediable.
Health systems themselves are important determinants of health and health equity. They can perpetuate health inequities by reflecting structural racism and discriminatory practices of wider society. For instance, systemic racism, implicit bias, misinformed clinical practice, or discrimination by health professionals contributes to health inequities. However, health systems can also be a leading force for tackling the inequities faced by populations experiencing racial discrimination.
Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
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A case study of the Essential Health Benefit in Tanzania mainland
Todd G.; Nswilla A.; Kisanga O.; Mamdani M.
Regional Network for Equity in Health in east and southern Africa (EQUINET)
(2017)
C1
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 109
This report describes the evolution of mainland Tanzania’s EHB; the motivations for developing ... the EHBs, the methods used to develop, define and cost them; how it is being disseminated, communicated, and used; and the facilitators (and barriers) to its development, uptake or use. Findings presented in this report are from three stages of analysis: literature review, key informant perspectives and a national consultative meeting. more
This report describes the evolution of mainland Tanzania’s EHB; the motivations for developing ... the EHBs, the methods used to develop, define and cost them; how it is being disseminated, communicated, and used; and the facilitators (and barriers) to its development, uptake or use. Findings presented in this report are from three stages of analysis: literature review, key informant perspectives and a national consultative meeting. more
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 syst
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ems 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. The Alma-Ata Declaration of 1978 reaffirmed the ri
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ght 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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