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Health system resilience is not an inevitable byproduct of any investment in health but must be intentionally programmed and developed with necessa
...
ry input, investment and contextualization. This technical product aims to guide national, subnational, and global health actors to operationalize the concept of health system resilience for advancement of universal health coverage, health security and ultimately better health for all. It supports the translation of relevant conceptual guidance and high-level recommendations into practical actions.
The specific objectives are to:
present a concise overview of the concept of health system resilience;
provide a roadmap outlining practical and foundational steps for building health system resilience to be adapted to different contexts;
share examples of actions and tools, including stakeholder roles, to support country application of the roadmap.
The target audience for this work is the various stakeholders involved in strengthening health systems and public health including management of emergencies (from prevention and preparedness to response and recovery) and other public health challenges in countries. This ranges from the donors, policy-makers and decision-makers at global, national and subnational levels to the implementing institutions and line managers of health system functions and services across the health system building blocks.
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The Health Sector Policy gives general orientations for the sector which are further developed in the various sub-sector policies guiding key health programs and departments. All
...
health sub-sector policies will be updated in line with this new policy. The Health Sector Policy is the basis of national health planning and the first point of reference for all actors working in the health sector. The overall aim of this policy is to ensure universal accessibility (in geographical and financial terms) of equitable and affordable quality health services (preventative, curative, rehabilitative and promotional services) for all Rwandans. It sets the health sector’s objectives, identifies the priority health interventions for meeting these objectives, outlines the role of each level in the health system, and provides guidelines for improved planning and evaluation of activities in the health sector. A companion Health Sector Strategic Plan (HSSP) elaborates the strategic directions defined in the Health Sector Policy in order to support and achieve the implementation of the policy, and more detailed annual operational plans describe the activities under each strategy.
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A System of Health Accounts 2011: Revised edition
Organisation for Economic Co-operation and Development (OECD), Eurostat and World Health Organization (WHO)
OECD Publishing, Paris
(2017)
CC
A System of Health Accounts 2011: Revised Edition provides an updated and systematic description of the financial flows related to the consumption of heal
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th care goods and services. As demands for information increase and more countries implement and institutionalise health accounts according to the system, the data produced are expected to be more comparable, more detailed and more policy relevant. It builds on the original OECD Manual, published in 2000, and the Guide to Producing National Health Accounts to create a single global framework for producing health expenditure accounts that can help track resource flows from sources to uses. It is the result of a collaborative effort between the OECD, WHO and the European Commission, and sets out in more detail the boundaries, the definitions and the concepts – responding to health care systems around the globe – from the simplest to the more complicated.
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Providing sutstainable mental and neurological health care in Ghana and Kenya
Sheena Posey Norris, Erin Hammers Forstag, and Bruce M. Altevogt
Forum on Neuroscience and Nervous System Disorders; Board on Health Sciences Policy; Board on Global Health; Publisher: National Academic Press
(2016)
C2
The Government of Malawi is committed to improving health and livelihoods in Malawi through community health – the
provision of basic health ser
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vices in rural and urban communities with the participation of people who live there.
Historically, Community Health has significantly contributed to improvements in Malawi’s health outcomes in particular
attainment of MDG4. However, the community health system faces resource constraints and inconsistencies around quality
of service – which negatively affect health outcomes.
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This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the
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health system and the community. While this position provides CHWs with a good platform to improve community health, a major challenge in large-scale CHW programmes is the need for CHWs to establish and maintain benefcial relationships with both sets of actors, who may have diferent expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities.
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his practical Guide serves as a companion to the “WHO guideline: recommendations on digital interventions for health system strengthening” and provides a systematic process for countries to deve
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lop a costed implementation plan for digital health within one or more health programme areas, drawing guidance from the WHO guideline–recommended digital health interventions, providing direction to ensure investments are needs-based and contribute effective and interoperable systems aligned with national digital architecture, country readiness, health system and policy goals.
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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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This Eye health strategic plan presents the Ministry of Health’s five
year proposed strategies for eye care in Kenya. It sets the strategic
direction for the
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National Eye Health Care System and presents
information on the priorities, objectives and indicators that the
Ministry has adopted especially with regard to the main eye diseases
and conditions in the country and health system strengthening.
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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
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)
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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
Oral diseases are among the most common chronic diseases worldwide and constitute a major public health problem due to the huge health and economic burden on individuals, families, societies, and
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health care systems. The recent emphasis on the role of determinants of health, common risk factors and their recognition in the context of the growing burden of noncommunicable diseases (NCDs) provides good opportunities for integrating oral health into NCD prevention and control efforts. This Strategy for oral health in South-East Asia, 2013-2020, presents guidance to Member States in developing national policy and action plans to improve oral health within existing socioeconomic, cultural, political and health system contexts. It expresses the consensus on major strategies in the area of oral health promotion as well as oral disease prevention and control for the South-East Asia Region aiming at reducing the health and socioeconomic burden resulting from oral diseases, reducing oral health inequities, and improving the quality of life of the population.
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Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. Howe
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ver, consolidation of CHVs position within formal health systems has proved to be complex and continues to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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The National Health Plan (NHP) aims to strengthen the country’s health system and pave the way
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towards Universal Health Coverage (UHC),choosing a path that is explicitly pro-poor. The main goal of NHP 2017-2021 is to extend access to a Basic Essential Package of Health Services (EPHS) to the entire population by 2020 while increasing financial protection.
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The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches document is part of the WHO Guidance and technical packages on community mental health serv
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ices set of publications. It provides a detailed description of person-centred and human rights-based approaches in mental health, and summary examples of good practice services around the world. It describes the linkages needed with housing, education, employment and social protection sectors, and presents examples of integrated regional and national networks of community-based mental health services. Specific recommendations and action steps are presented for developing community mental health services that respect human rights and focus on recovery. This comprehensive document is accompanied by a set of seven technical packages focused on specific categories of mental health services and guidance for setting up new services.
The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches is a set of publications that provides information and support to all stakeholders who wish to develop or transform their mental health system and services to align with international human rights standards including the UN Convention on the Rights of Persons with Disabilities.
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WHO guideline on health policy and system support to optimize community health worker programmes
recommended
The guideline uses state-of-the-art evidence to identify effective policy options to strengthen community health worker (CHW) programme performance through their proper integration in health systems
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and communities.
Successful delivery of services through CHWs requires evidence-based models for education, deployment and management of these health workers. The guideline is intended as a tool for national policy makers and planners and their international partners to use in the design, implementation, performance and evaluation of effective community health worker programmes. It contains pragmatic recommendations on selection, training and certification; management and supervision: and integration into health systems and community engagement.
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A practical approach for developing policy and strategy to improve quality of care
The handbook outlines an approach for the development of national policies and strategies to improve the quality of care. Such policy and strategy can help clarify
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the structures, roles and responsibilities within national quality efforts, support the institutionalization of a culture of quality, and secure buy-in from health system leaders and stakeholders
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Health, safety and wellbeing of the Healthcare workers is a prerequisite for good quality of care and patient satisfaction in health services. Healthcare facilities that are not safe for workers and
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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.
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