Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary 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 primar...y 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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There are many calls for improved integration between
primary care and public health, but also sizeable obstacles to achieving
this, such as differences in the ways the two sectors are organised and
financed, as well as differences in education, culture and approach.
This article, based on a new... Observatory policy brief, describes the
types of interventions that come into consideration, the principles
that should be followed, and the factors that can facilitate successful
collaboration. While there is no universal template that can be followed
by all countries, improved integration promises to yield substantial
benefits to patients and wider populations.
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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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Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit...h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
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When situations occur in which unwanted events are rightly or wrongly connected with vaccination, they may erode confidence in vaccines and the authorities delivering them. This document presents the scientific evidence behind WHO’s recommendations on building and restoring confidence in vaccines ...and vaccination, both in ongoing work and during crises. The evidence draws on a vast reserve of laboratory research and fieldwork within psychology and communication. It examines how people make decisions about vaccination; why some people are hesitant about vaccination; and the factors that drive a crisis, covering how building trust, listening to and understanding people, building relations, communicating risk and shaping messages to the audiences may mitigate crises. This document provides a knowledge base for stakeholders who develop communication strategies or facilitate workshops on communication and trust-building activities in relation to vaccines and immunization, such as immunization programme units, ministries of health, public relations and health promotion units, vaccine safety communication trainers and immunization advisory bodies.
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In order to meet changing global population needs and consumer expectations, healthcare systems worldwide are under transformation and face restructuring. As systems adapt and shift their emphasis in response to the disparate requests for healthcare services, oppor-tunities emerge for nurses, especi...ally the APN, to meet these demands and unmet needs (Bryant-Lukosius et al. 2017; Carryer et al. 2018; Cassiani & Zug 2014; Cooper & Docherty 2018; Hill et al. 2017; Maier et al.2017). In 2002, the International Council of Nurses (ICN) pro-vided an official position on Advanced Practice Nursing (ICN 2008a). Since that time, worldwide development has increased significantly and simultaneously this field of nursing has matured. ICN felt that a review of its position was needed to assess the relevance of the definition and characteristics offered in 2002. This guid-ance paper defines diverse elements such as assump-tions and core components of the APN. The attributes and descriptors presented in this paper are intended to promote a common vision to continue to enable a greater understanding by the international nursing and healthcare communities for the development of roles commonly identified as Clinical Nurse Specialist (CNS) and Nurse Practitioner (NP).
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This article looks at the Baseline Standards developed by the International Society for Paediatric
Oncology (SIOP) for paediatric oncology nursing care in low- and middle-income countries. The
Baseline Standards lay the foundation for effective care and address barriers such as inadequate
staffin...g levels, lack of support, limited access to nurse education and unsafe nursing environments.
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Tackling COVID-19 misinformation. Ensuring communities have access to lifesaving public health information from trusted sources and are not misled by misinformation is essential to ending the COVID-19 pandemic.
In an effort to empower doctors and nurses – some of the most effective and trusted... messengers of public health information – to actively address COVID-19 misinformation and build vaccine confidence globally, the WHO welcomes this social media toolkit for healthcare practitioners, developed by the Government of the United Kingdom.
This toolkit aims to provide healthcare workers with the tools, skills and content needed to effectively share authentic and reliable information online. Centered around three core vaccine confidence messages, Vaccine Safety, Vaccine Development and Vaccine Reducing Risk of Sickness; this toolkit sets out three approaches: creating your own posts, posting the images and videos provided in the toolkit, or resharing vaccine information from trusted sources.
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Early damage assessments indicate that at least 800,000 people could be directly exposed to minor to severe damages, including communication, access, security, loss of livelihoods, infrastructure, and health services could be impacted.
The World Health Organization’s comprehensive antenatal care (ANC) guideline WHO recommendations on antenatal care for a positive pregnancy experience was published in 2016 with the objective of improving the quality of routine health care that all women and adolescent girls receive during pregnan...cy. The overarching principle – to provide pregnant service users with a positive pregnancy experience – aims to encourage countries to expand their health-care agendas beyond survival, with a view to maximizing health, human rights and the potential of their populations. Recognizing that ANC provides a strategic platform for important health-care functions, including health promotion and disease prevention, 14 out of the 49 recommendations in the WHO 2016 ANC guideline relate to nutrition in pregnancy.
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A technical and environmental comparative overview of common shelter typologies found in settlements across UNHCR operations
Since the launch of the 2012–2020 World Health Organization (WHO) road map for the control, elim-ination and eradication of neglected tropical diseases (NTDs) (1), considerable progress against NTDs has been made. Between 2010 and 2020, the number of people requiring interventions against NTDs glo...bally fell by 600 million, and 42 countries, areas and territories eliminated at least one NTD (2). In January 2021, a new NTD road map for 2021–2030 (2) was launched, setting future targets and mile-stones for 20 diseases and disease groups. The road map also sets cross-cutting targets, including for strengthened capacity of national health systems to deliver interventions through existing infrastructure.
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On 25 August, UN agencies and partners launched a US$187.3 million Flash Appeal to reach 500,000 of the most vulnerable people affected by the 14 August earthquake.
Around 650,000 people are in need of emergency humanitarian assistance in the three most affected departments – Grand’Anse, Nipp...es and Sud – where 634,000 were already in need of multisectoral assistance before the quake.
Based on lessons learned from past emergencies, humanitarian actors are aiming to capitalize on local and national level expertise, capacities and knowledge to promote a rapid and effective response tailored to the expressed needs of affected people.
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Orientations provisoires 19 juillet 2021
interim guidance, 19 July 2021 (arabic version)
La presente publicación describe la evidencia científica disponible sobre la utilidad del uso complementario de pruebas moleculares y de detección de anticuerpos para mejorar el diagnóstico de sospechosos de COVID-19. La utilización complementaria de ambas pruebas podría mejorar la identificac...ión correcta de pacientes con COVID-19, incluyendo a los pacientes asintomáticos o con enfermedad leve, contribuyendo a disminuir su propagación.
Esta publicación pertenece al compendio Publicaciones Minsa sobre COVID-19
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This inter-agency guidance document aims to supplement the COVAX demand creation package for COVID-19 vaccines with key considerations for humanitarian contexts and marginalized populations with specific access and communication needs.
21 Sept.2021
The state of the Guinean health workforce is one of the country’s bottlenecks in advancing health outcomes. The impact of the 2014–2015 Ebola virus disease outbreak and resulting international attention has provided a policy window to invest in the workforce and reform the health system. This re...search constitutes a baseline study on the health workforce situation, professional education, and retention policies in Guinea. The study was conducted to inform capacity development as part of a scientific collaboration between Belgian and Guinean health institutes aiming to strengthen public health systems and health workforce development. It provides initial recommendations to the Guinean government and key actors.
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