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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, foll ... owed 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, foll ... owed 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
It highlights the numerous challenges to quality service provision, along with the organisation’s response to mental health needs, and recommendations for international and regional decision-makers including:
- Advocating and working towards mental health policies that support adequate funding f
...
or mental health care and government suppor
- Legislation to protect the rights of people with mental disorders and vulnerable communities
- Advocating for multi-year funding to support the sustainability of MHPSS programs
- Creating capacity building opportunities consistent with the IASC guidelines and supported with continuous supervision
more
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 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.
more
BMJ Glob Health 2019;4:e001272. doi:10.1136/bmjgh-2018-001272
Trust is an essential component of successful cooperative endeavours. The global health response to the 2014–2016 West Africa Ebola outbreak confronted historically tenuous regional relationships of trust. Challenging sociopolitical co
...
ntexts and initially inappropriate communication strategies impeded trustworthy relationships between communities and responders during the epidemic. Social scientists affiliated with the Ebola 100-Institut Pasteur project interviewed approximately 160 local, national and international responders holding a wide variety of roles during the epidemic
more
Nearly half the population of Sierra Leone is under the age of 18 years and the impact of the Ebola crisis on their lives now and on their future opportunities has been far-reaching: no school; loss of family members and friends to the virus; and changing roles and responsibilities in the home and t
...
he community.
While the priority now remains meeting the goal of zero cases, the Government of Sierra Leone (GoSL) is also developing a comprehensive strategy aimed at supporting communities to recover from this crisis, to put the country back on track to meet development targets. The Ebola Recovery Strategy – currently being finalised by the GoSL – represents a potentially transformative framework to support the immediate recovery of children from the crisis and to ensure their place in the future development of Sierra Leone.
To date, there has not been a formal process for children to outline their own priorities for recovery to decision-makers. In mid-March 2015, child-centred agencies conducted a Children’s Ebola Recovery Assessment (CERA) in nine districts across Sierra Leone to create a mechanism for more than 1,100 boys and girls, to discuss issues of concern; assess the impact of the crisis on their roles, responsibilities and future opportunities; and to formulate their recommendations for recovery.
more
This report, written in partnership with various Royal Medical Colleges and Public Health England, sets out the essential actions to improve the physical health of adults with severe mental illness (SMI) across the NHS. The report makes practical recommendations for changes that will help adults wit
...
h SMI to receive the same standards of physical healthcare as the general population and reduce the risk of premature death.
more
Some 32% of internally displaced persons (IDPs) in Ukraine suffer from post-traumatic stress disorder (PTSD) as a result of the conflict in the east.
Among the 2,203 respondents surveyed across Ukraine, the study also found a high prevalence of mental disorders such as depression (22%) and anxiety
...
(17%), particularly among women. This has a significant effect on family and community relations, the ability to work or even do basic tasks such as walking.
Moreover, the study noted that 74% of respondents in need of psychiatric care do not receive it, mainly due to a high cost of mental healthcare and medicine.
more
Plan Benin used the Integrated Management for Child Illnesses (IMCI) framework in creating the project "Collaborative Approach to Community based Malaria Prevention.” The project targeted 20 pilot villages in the communes of Aplahoué and Djakotomey, with the goal of reducing maternal and infant m
...
ortality related to malaria in the Couffo district. In order to assess the effects of the project on the beneficiary communities, the evaluation was initiated to measure the progress and the perfomance outcomes achieved at the end of the pilot stage. The evaluation was conducted from March to April 2009.
more
Antimicrobial resistance (AMR) is a global threat that requires urgent collaborative action within and among countries. AMR makes standard treatments ineffective and facilitates the spread of antimicrobial resistant infections rendering communities
...
vulnerable. The Ministry of Health (MOH) and Ministry of Agriculture, Livestock, Fisheries & Blue Economy (MALF) recognized antimicrobial resistance as a priority following findings from status reports and studies from Ministries, Departments, Agencies and Stakeholders.
more
Not all that bleeds is Ebola
recommended
How has the DRC Ebola outbreak impacted Sexual and Reproductive Health in North-Kivu?
Recommendations (more specifics found in the assessment):
1. Sexual and reproductive health needs and services are to be embedded in the EVD response from the outset.
2. Reduce delays at every stage of the patie
...
nt journey, particularly for women experiencing obstetric complications, including complications from abortion.
3. Support individuals and communities to mitigate SRH risks posed during and after EVD epidemic:
4. Formulate SRH guidelines for the EVD context involving experts in all relevant fields.
more
According to the National Institute of Statistics and Demography (NSID) 168,094 persons out of Burkina Faso’s 14,017,262 inhabitants are living with a physical, sensory or mental disability. The numbers are questioned as the effort to collect in-depth statistics has not been great. Furthermore, mu
...
ch of the statistics is only collected in more densely populated provinces and towns and not in smaller rural communities. Handicap International (HI) estimates that the number is as high as 7 per cent.
more
Risk Communication and Community Engagement (RCCE) is an essential component of your health emergency preparedness and response action plan. This tool is designed to support risk communication, community engagement staff and responders working with national health authorities, and other partners to
...
develop, implement and monitor an effective action plan for communicating effectively with the public, engaging with communities, local partners and other stakeholders to help prepare and protect individuals, families and the public’s health during early response to COVID-19.
more
Updated 8 June 2021. Coronavirus is spreading globally. How can individuals, communities, humanitarian actors, local and national authorities best respond to uphold the rights of all affected people?
It is too early to know the full impact of COVID-19 on Africa. To date the experience has been varied. There are causes for concern, but also reasons for hope. Early estimates were pessimistic regarding the pandemic’s impact on the continent. But the relatively low numbers of COVID-19 cases report
...
ed thus far have raised hopes that African countries may be spared the worst of the pandemic. While the virus is present in all African countries, most countries have recorded fewer than 1,000 cases. The African Union acted swiftly, endorsing a joint continental strategy in February, and complementing efforts by Member States and Regional Economic Communities by providing a public health platform.
more
COVID-19 disproportionately affects the poor and vulnerable. Community health workers are poised to play a pivotal role in fighting the pandemic, especially in countries with less resilient health systems. Drawing from practitioner expertise across four WHO regions, this article outlines the targete
...
d actions needed at different stages of the pandemic to achieve the following goals: (1) PROTECT healthcare workers, (2) INTERRUPT the virus, (3) MAINTAIN existing healthcare services while surging their capacity, and (4) SHIELD the most vulnerable from socioeconomic shocks. While decisive action must be taken now to blunt the impact of the pandemic in countries likely to be hit the hardest, many of the investments in the supply chain, compensation, dedicated supervision, continuous training and performance management necessary for rapid community response in a pandemic are the same as those required to achieve universal healthcare and prevent the next epidemic.
BMJ Global Health2020;5:e002550. doi:10.1136/bmjgh-2020-002550
more
Despite the increasing population of refugees stuck in protracted situations and our awareness of the vulnerability of children and adolescents growing in up these contexts, relatively little is known about community based child protection mechanisms (CBCPMs) in refugee
...
communities. CBCPMs, defined broadly, include all groups or networks that respond to and prevent problems of child protection and vulnerable children. These mechanisms may include family supports, peer group supports, and community groups such as primary and secondary schools, non-formal education and vocational training structures, women’s groups, religious groups, and youth groups, as well as traditional community processes, government mechanisms, and mechanisms initiated by international or domestic non-governmental organisations (NGOs). In diverse contexts, CBCPMs represent front-line, day-to-day efforts to protect children from exploitation, abuse, violence, and neglect and to promote children’s well being. This study, together with a parallel study conducted among the urban refugee population in Uganda, is the first study of CBCPMs undertaken in refugee settings.
more
In Israel, as in other countries, the COVID-19 outbreak highlights existing structural inequities,which compromise the health of some migrant groups. The Israeli case also demonstrate show strong NGOs successfully advocate for the protection of migrants‘health amidst the crisis, madepossible bya c
...
ertain level ofcooperation withthe Israeli Ministry of Health.Hence,measures for COVID-19preparedness in Israel‘s marginalized migrant communities mostly result from pressure from civil society, against thebackdrop of a generally exclusionary approach toward migrants.4Over time, the Israeli Ministry of Health thus shifted from acknowledging the need to include migrants in preparedness measures toward the realization that particular needs and circumstances amongmigrant communities in some instances require special responses. Givena legacy of neglect and exclusion, this creates challenges for both the authorities and the migrant communities.
more
The number of confirmed COVID-19 cases detected and reported in each country is influenced by
many factors including limited access and/or utilization of healthcare and COVID-19 testing, limited
surveillance, lack of knowledge amongst the populati
...
on about when to seek testing, an asymptomatic presentation, and other unknown issues. This is true in all countries of the world, and not Africa specific, however there are factors unique to Africa which may also affect the way the virus behaves there. COVID-19 prevalence data are critical for planning effective mitigation strategies and understandingthe true impact of the disease and relevant intervention measures in Africa, which might be quite different from regions with a different population age distribution or risk factor profile.
more
Just about everyone has experienced the joy that a healthy newborn child brings to parents, families and communities. But the arrival of a newborn who is small or sick often results in immediate worry and sadness. When the infant is at high risk of
...
death or disability, these concerns can be a tremendous additional burden.
more
