The publication is designed to provide Ipas staff, trainers, partners and other health-care providers with access to up-to-date, evidence-based recommendations. In general, the recommendations are the same as those in the World Health Organization’s 2012 Safe Abortion: Technical and Policy Guidanc...e for Health Systems, Second edition. In rare cases, the recommendations have been modified due to the settings where Ipas works. In addition, if there is more current evidence to inform the recommendations, they will be updated here.
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Each year, about 210 million women become pregnant and about 140 million newborn babies are delivered. The sheer scale of maternal health issues makes maternal well being and survival vital concerns. A decade after The Lancet published a Series on maternal survival, a new Series of six papers brings... our knowledge of maternal health, its epidemiology, successes, and current failings together, and at a crucial time within the sustainable development framework to 2030. The Series concludes with a call to action setting out five key targets which need to be met to ensure the progression of broader sustainable development goals (SDGs).
Open Access
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Policy Note #1: Myanmar Health Systems in Transition Policy Notes Series
The Government of the Republic of the Union of Myanmar is committed to achieving universal health coverage (UHC) by 2030. In practice, this means that over the next 15 years the aim is to progressively ensure that all peop...le in all parts of the country have access to the health-care services they need – both preventive and curative – without suffering financial hardship when paying for them.
This policy note is the first in a set of four. It provides an overview of the challenges to be overcome in making progress toward UHC and sets out recommendations for how they can be tackled. The other notes look in more detail at three specific issues: how UHC can improve equity, and how strengthening the township health system and expanding financial risk protection contribute to UHC.
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Data on the essential building blocks of mental health systems, including mental health
governance, financing, service delivery, human resources and information, are reported. For
mental health planning, it is important to know not only the level of resources in these six areas,
but also how thos...e resources are being organized and utilized. Thus, data on efficiency, access,
equity, linkages with other sectors and respect for human rights are reported as well.
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Internally displaced persons (IDPs), refugees, migrants and returnees constitute a sizeable population in the WHO Eastern Mediterranean Region. There were 12 million refugees (half are Palestinians) and 13 million IDPs in the Region as of 2018. These populations are often vul...nerable to poor health due to the conditions they live in and limited access to needed quality health care. In addition, those who can access care, are often faced with financial hardship. There are also 46 million professionals and low-income labour migrants in the Region (of which 22 million are from the Region), with differential access to health services and varied health coverage schemes
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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 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.
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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 systems [1, 2]. Robust resea...rch 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.
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CHWs are trained public health workers who serve as a bridge between communities, health care systems, and state health departments.
Resources on this page include:
Online courses, lessons learned, and best practices to help state health departments train and further build capacity for CHWs in th...eir communities.
Training and education materials for CHWs to use within their communities.
accessed 23.07.2021
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The world is facing an unprecedented range of emergencies. In reaction to these complex adversities, many people experience considerable distress and impairment, and a minority may even go on to develop mental health conditions. Meanwhile, those with pre-existing mental health conditions may experie...nce a worsening of their condition and are at risk of neglect, abandonment, abuse and lack of access to support. Unfortunately, evidence-based mental health care is often extremely limited in humanitarian settings. In response, the World Health Organization (WHO) and the United Nations High Commissioner for Refugees (UNHCR) published the Mental Health Gap Action Programme (mhGAP) Humanitarian Intervention Guide (mhGAP-HIG) in 2015. This practical tool supports health-care providers in assessing and offering first-line management of mental, neurological and substance use (MNS) conditions in humanitarian emergency settings.
2 December 2021. The current report, Stories of change from four countries: Building capacity for integrating mental health care within health services across humanitarian settings, describes efforts in four countries to build evidence-based mental health systems in humanitarian emergency settings using the mhGAP-HIG. This report includes three sections, the first describing the importance of scaling up mental health care in emergency contexts, the second outlining case studies (“stories of change”) to scale up the Mental Health Gap Action Programme (mhGAP) programme in four settings and the third describing lessons learned by stakeholders.
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This visual guide provides an overview of the various means of support WHO offers to member states to advance climate-resilient health. The guide offers answers to key questions to understand WHO's support to countries on climate change and health, including: What are the impacts of climate change o...n health and the potential health co-benefits of climate change mitigation? How do we develop comprehensive plans and strategies to address climate-sensitive health risks and build climate-resilient health systems and facilities?
How do we access climate financing for climate change and health, including the Green Climate Fund (GCF) Readiness programme? What interventions can be implemented to address climate-sensitive health risks and strengthen the resilience and environmental sustainability of health systems and facilities? How do we monitor progress made at national level on climate change and health?
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The Lancet. 13 March 2022. doi: 10.1016/S0140-6736(21)02868-3. Previous Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) studies have reported
national health estimates for Ethiopia. Substantial regional variations in socioeconomic status, population, demography, and access to hea...lth care within Ethiopia require comparable estimates at the subnational level. The GBD 2019 Ethiopia subnational analysis aimed to measure the progress and disparities in health across nine regions and two chartered cities.
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Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant barriers to access mental health services in Chile, ...coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis.
Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics.
Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19.
Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.
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Ensuring mental health and well-being has become a worldwide imperative and an important target of the Sustainable Development Goals. But in all countries around the world, our response has been woefully insufficient, and we have made
little progress to advance mental health as a fundamental human ...right.
One in ten people are affected by a mental health condition, up to 200 million people have an intellectual disability and an estimated 50 million people have dementia. Many persons with mental health conditions, or psychosocial, intellectual, or cognitive disabilities lack access to quality mental health services that respond to their needs and respect their rights and dignity.
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The main objective of the health systems is to meet the health needs of the population in general, but for this the system must have adequate financing and supply support to cover the entire population in question and check quality, efficiency, equity services, safety and sustainability. However, co...nsidering the segmented Peruvian health system, this makes it more deficient in comprehensive care for the population due to the duplication of functions, misuse of its resources, absence of complementary services. Due to the COVID-19 pandemic, this deficiency in the Peruvian health system became more evident owing to the high number of
deaths and its state of collapse, combining these factors this scope review aims to map the current state of the Peruvian health system, its structure, synthesize data on the performance of the health system (in terms of access, coverage and quality of health services) and identify the main public health policies available
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Monitoring financial protection and utilization of health services in Mongolia 2009-2018 is based on national representative household socioeconomic surveys. The study finds that between 2009 and 2018, despite ambitious health reforms, the incidence of catastrophic health spending and impoverishing ...spending at the relative poverty line have increased. These increases were mainly driven by out-of-pocket spending on medicines and inpatient care. In the same period, inequity in access to and utilization of health services remained constant among population groups. Evidence suggests health financing policies need to be further strengthened to make progress towards universal health coverage. Continuous tracking of out-of-pocket payments and service utilization to inform policymaking is needed.
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This brochure presents a summary of the situation of health systems and services in the Americas as they progress toward the achievement of universal access to health and universal health coverage (universal health). The information provided presents an overview of the situation before the COVID-19 ...pandemic, how the pandemic has impacted health systems, and recommendations to address current and future challenges for building resilient health systems to advance toward universal health in the Americas.
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Medical care for people caught up in armed conflict and other insecure environments saves lives and alleviates suffering. It is one of the most immediate and high priority needs of an affected population and is often the first type of response activated and/or requested by authorities and affected c...ommunities. Medical teams working in armed conflict and other insecure environments
frequently face serious threats to their security and safety, challenges to patient access, and at times limited acceptance by affected communities in which they work and parties to the conflict. Such difficulties are likely to increase (6) and
thereby creating a critical need to establish contact and trust with all sides in conflicts and in other insecure environments to ensure operational continuity. This trust can best be achieved when all sides perceive the medical teams to be neutral, impartial, and independent, and specifically not aiding (or being perceived to aid) any one party to achieve a military, political or economic
advantage. For medical teams that are deploying increasingly closer to the frontlines, the implications of and consequences for both staff and patients of teams not being fully prepared, and/or not fully comprehending the context in which they work, can be severe. Medical response can easily be hindered or compromised by intentional or unintentional acts and the behaviour and
conduct of the teams themselves
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The chapter Closing the Gap: The Health Disparities of Older LGBTI People in the Americas, is part of the publication series titled ‘Decade of Healthy Aging: situation and challenges’. In order to outline the current knowledge available on the situation of health and well-being of older persons ...in the Americas at the beginning of the United Nations Decade of Healthy Aging (2021-2030), this document presents data and existing evidence different forms of discrimination and mistreatment older people face due to their sexual orientation and gender identities that ultimately increase health disparities. Previous studies on LGBTI older people offer valuable information on the lived experiences of these communities and demonstrate that they face unique challenges with aging, emphasizing the difficulties related to access to care. Very few studies on older people and aging include a focus on sexual orientation or gender identity; however, it is possible to point out that HIV/AIDS is one of the most significant health disparities confronting LGBTI older persons, followed by physical and mental health problems, substance use, social isolation, poverty, and the lack of access to quality healthcare, including long-term care facilities or other institutions. Closing the gap in access and quality of health and care services is an imperative to increase longevity, health status and quality of life of LGBTI older people.
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The WHO Disability-Inclusive Health Services Training Package is a companion to the “WHO Disability-Inclusive Health Services Toolkit: A resource for health facilities in the Western Pacific Region” published by WHO in 2020. This package offers a range of additional training materials including ...presentations, workbooks and videos that will allow users to develop the foundational skills and understanding of the Toolkit for its implementation. Together the Toolkit and Training Package will help ensure equitable access to health services, best-quality outcomes and improved quality of life for all people with disabilities to achieve universal health coverage.
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More than 40% of the world population is 24 years old or younger, the vast majority of whom live in low- and lower middle–income countries. Globally, a quarter of disability-adjusted life years (DALYs) for mental disorders and substance abuse is borne by this age group and about 75% of mental diso...rders diagnosed in adulthood have their onset before the age of
24 years . Most children and young people in developing countries, however, do not have access to mental health care.
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