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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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This document shall serve as the most comprehensive set of guidelines on the safe management of waste generated from heath care activities in the country. It incorporates the requirements of all Philippine laws and regulations governing HCWM and is designed for the use of individuals,
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public and private establishments, and other entities involved in segregation, collection, handling, storage, treatment,and disposal of waste generated from heath care activities.
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This report aims to support countries in the necessary transition toward healthier, more sustainable diets by integrating biodiversity in food-based interventions to support nutrition and health. It is intended to help guide decision-makers in the
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health, nutrition and other sectors, to:
Consider the important role of biodiversity in food systems for the development of integrated interventions to support healthy, diverse and sustainable diets;
To focus investments and country support for more comprehensive, coordinated and cross-cutting public health and nutrition projects and policies; and
To strengthen the resilience of food systems, health systems, and societies, each of which are each increasingly compromised by widespread ecological degradation, biodiversity loss and climate change.
Biodiversity at every level (genetic, species and ecosystem level) is a foundational pillar for food security, nutrition, and dietary quality. It is the basic source of variety in essential foods, nutrients, vitamins and minerals, and medicines, and underpins life-sustaining ecosystem services. It is a core environmental determinant of health, often a vital ingredient of healthy nutritional outcomes and livelihoods, gender equality, social equity, and other health determinants.
Biodiversity can play a more prominent role in planning for nutritional outcomes in various ways, e.g. by facilitating the production of nutritious fruits and plant products, sustaining livelihoods through more efficient production and increasing the diversity of products available in markets. This Guidance presents and expands on six core building blocks for mainstreaming biodiversity for nutrition and health:
Cross-sectoral knowledge development and knowledge co-production;
Enabling environments;
Integration;
Conservation and the wider use of biodiversity;
Education and awareness-raising;
Monitoring and evaluation;
This WHO report builds on an unprecedented opportunity to mainstream biodiversity in order to support healthy and sustainable diets, and offers the necessary technical guidance to catalyze and support a transformation of the global food system and transition to healthier, more sustainable diets.
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This publication presents a comprehensive methodology to support the Member States of the Pan American Health Organization (PAHO) in preparing for and responding to heat-health risks in the Region o
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f the Americas. It builds on World Health Organization and the World Meteorological Organization global documents, as well as on the disaster preparedness methodologies employed throughout the countries of the Region. This publication is part of an effort coordinated by PAHO to support Member States in multihazard preparedness, and includes: early warning system strengthening; threat characterization; activation and deactivation procedure definition; and institutional coordination. It engages different disciplines and recognizes the importance of intersectoral collaboration to respond to heat-health risks. It aims to bring awareness of the impacts of heat on the health of people of the Americas to public health decisionmakers, and thereby strengthen health service provision.
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This companion document to Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030 ("the road map") aims to support a range of stakeholders - including countries in which neglected tropical diseases (NTDs) are endemic, international organi
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zations and non-State actors - to achieve the road map targets through a transdisciplinary, cross-cutting One Health approach. Specifically, it provides guidance on the One Health actions needed by major stakeholders and how to support a paradigm shift towards One Health in national NTD programmes. Examples of common One Health challenges and how they can be overcome as well as illustrative cases studies are provided throughout. The companion document was developed through a global consultative process involving stakeholder interviews, interactive workshops, and online public consultation.
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This publication presents the Agenda for the Americas on Health, Environment, and Climate Change 2021–2030 (the Agenda). The Agenda is a call to action to the health sector to lead the charge to a
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ddress environmental determinants of health in the Americas. The Pan American Health Organization (PAHO) will work with Member States to achieve its goal and objective to ensure healthy lives and promote well-being for all at all ages using a sustainable and equitable approach that places a priority on reducing health inequity. The Agenda has been developed under the umbrella of the WHO Global Strategy on Health, Environment, and Climate Change, and builds upon the commitments set forth in the Sustainable Health Agenda for the Americas 2018–2030 and the PAHO Strategic Plan 2020–2025. The Agenda was developed in consultation with the Technical Advisory Group and through a consensus-driven decision-making process with Member States during the 2019–2020 period. Looking toward the achievement of Sustainable Development Goal 3, the Agenda focuses on: improving the performance of environmental public health programs and institutions; fostering environmentally resilient and sustainable health systems; and promoting environmentally healthy and resilient cities and communities. Its implementation will be context-specific, based on the needs and realities of the countries. It will benefit countries and territories by promoting good governance practices, strengthening the leadership and coordination roles of the health sector, fostering cross-sectoral action, focusing on primary prevention, and enhancing evidence and communication. It will facilitate access to human, technical, and financial resources necessary to address environmental determinants of health and ensure that the Region is fully engaged in global health, environment, and climate change processes and agreements. The objective of the Agenda is to strengthen the capacity of health actors in the health and non-health sectors to address and adapt to environmental determinants of health (EDHs), prioritizing populations living in conditions of vulnerability, in order to meet Outcome 18 of the PAHO Strategic Plan 2020–2025 directly and several other outcomes of the Plan indirectly. To address and adapt to the challenges of EDHs in the Region, an integrated and evidence-informed approach within the health sector and across sectors will be needed, one enabled, and supported by good governance practices, adequate management mechanisms, high-level political will, and adequate human, technical, technological, and financial resources.
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The climate crisis has many consequences – among them widespread health impacts that will lead to immense societal, ecological, and economic harm.
Over the past two decades multiple large-scale reviews on climate change and
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health have made clear the need for a multi-sectoral approach to target the drivers and impacts of climate change, biodiversity loss, and ecosystem degradation. Despite this abundance of scientific evidence underscoring urgency of action, policy implementation responses lag behind. Even at COP26, itself delayed due to an ongoing pandemic, health continues to be considered by many countries a problem independent from climate and environment.
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The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on
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health at all country income levels underpinned the rise in health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
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To enhance health co-benefits across urban policies which tackle air pollution and climate change, WHO, in cooperation with various international, national, and local partners, implemented the Urban Health
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Initiative (UHI) pilot project in Accra, Ghana. The Initiative prompted the health sector to use its influential position to demonstrate to decision-makers and the public the full range of health, environmental and economic benefits that can be achieved from implementing local emission reduction and energy access policies and strategies. Policy tracking, although not always considered, is a fundamental component of this procedure. It assesses the planning, implementation and progress of a policy to refine or adjust policies with the final objective of increasing the likelihood of the policy being successful. This report is an outcome of the last component of the UHI model process, Policy tracking and monitoring outcomes. The report proposes a framework for tracking urban health policies, with a special focus on the impacts of air quality and energy access on human health and well-being in African countries, giving some examples from the pilot project in Accra. The report also provides resources to survey air quality in cities and other tools to assess public health and the environmental impacts of urban policies and monitor or track their effects.
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This guide presents a basis for understanding how diarrhoeal diseases are currently influenced by climate and weather, and may be further exacerbated by climate change. It is a technical guide on how to conduct a Vulnerability & Adaptation assessment for diarrhoeal diseases and climate change, and p
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rovides guidance on how to:
identify populations and regions vulnerable to diarrhoeal diseases and the reasons for their vulnerability;
establish relevant baselines that can be analysed and monitored;
conduct analyses to project how diarrhoeal diseases may be impacted in the future due to climate change; and
identify appropriate responses to mitigate and monitor these risks over time.
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Donor financing to low- and middle-income countries for reproductive, maternal, newborn, and child health increased substantially from 2008 to 2013. However, increased spending by donors might not improve outcomes, if funds are delivered in ways tha
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t undermine countries’ public financial management systems and incur high transaction costs for project implementation
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Benchmarking is a strategic process often used by businesses and institutes to standardize performance in relation to the best practices of their sector. The World Health Organization (WHO) and partners have developed a tool with a list of benchmark
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s and corresponding suggested actions that can be applied to implement the International Health Regulations 2005 (IHR) and strengthen health emergency prevention, preparedness, response and resilience capacities.
The first edition of the benchmarks was published in 2019 to support countries in developing, implementing and documenting progress of national IHR or health security plans (e.g. national action plan for health security (NAPHS), national action plan for emerging infectious diseases, public health emergencies and health security and other country level plans for health emergencies). The tool has been updated to incorporate lessons from COVID-19 and other health emergencies, to align with the updated IHR monitoring & evaluation framework (IHR MEF) tools and the health systems for health security framework, and to support strengthening health emergency prevention, preparedness, response and resilience (HEPR) capacities and the Preparedness and Resilience for Emerging Threats (PRET) initiative.
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Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure o
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n Africa’s already fragile health systems as ODA is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at
risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have
consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health.
In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to
213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals
per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more
Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance.
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This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in he
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alth financing. The report points out the need to improve public financial management within the health sector, for more efficient financial systems. It focuses on better resourceraising and utilization mechanisms. The matrix highlights the need for consolidation of fragmented health financing arrangements, for a more efficient health system. It also emphasizes the need for enhancing strategic purchasing of health services, to improve the overall efficiency and quality of care. Additionally, the report stresses the critical
role of leveraging data and information systems for more evidence-based informed decision-making. These recommendations are crucial for advancing Kenya’s health financing system and moving closer to the UHC goal.
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The report identifies major global gaps in WASH services: one third of health care facilities do not have what is needed to clean hands where care is provided; one in four facilities have no water services, and 10% have no sanitation services. This
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means that 1.8 billion people use facilities that lack basic water services and 800 million use facilities with no toilets. Across the world’s 47 least-developed countries, the problem is even greater: half of health care facilities lack basic water services. Furthermore, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning.
This report also describes the global and national responses to the 2019 World Health Assembly resolution on WASH in health care facilities. More than 70% of countries have conducted related situation analyses, 86% have updated and are implementing standards and 60% are working to incrementally improve infrastructure and operation and maintenance of WASH services. Case studies from 30 countries demonstrate that progress is being propelled by strong national leadership and coordination, use of data to direct resources and action, and the mutual benefits of empowering health workers and communities to develop solutions together.
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Promoting and protecting the mental health and psychosocial wellbeing of children, adolescents, and their caregivers remains undamental to achieving the Sustainable Development Goals (SDGs), with a direct contribution to SDG 3 (Good
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Health and Well- eing). In 2024, UNICEF accelerated the scale-up of integrated, multisectoral MHPSS programming. These efforts contributed to the strengthening of national and subnational child and adolescent mental health systems by supporting programming across the continuum of care, investing in workforce development, advancing data systems and evidence generation, and promoting institutional leadership and coordination mechanisms. UNICEF’s growing reach, particularly through health, education, and child protection systems, reflects a strategic commitment to embedding MHPSS in sustainable development frameworks and in responses that bridge humanitarian action and development programming.
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he UNFPA “Programmatic guidelines: Cash and Voucher Assistance in Sexual and Reproductive Health programming in Emergencies” explains how CVA can be effectively integrated into humanitarian responses
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to help women, girls, and other vulnerable groups access lifesaving and comprehensive SRH services. Rooted in UNFPA’s mandate, this document provides practical direction for designing, implementing, and monitoring CVA within SRH programming.
The guidance highlights the barriers that hinder access to SRH care, such as affordability, availability, acceptability, and appropriateness, and illustrates how CVA can address financial obstacles by covering transport, user fees, or other indirect costs, while reinforcing health system strengthening efforts. CVA is presented as a complementary tool that supports both emergency and long-term SRH goals. Within humanitarian emergencies, it can contribute directly to achieving MISP objectives, including:
Enabling survivors of sexual violence to access clinical and psychosocial care;
Supporting the continuation of HIV and STI treatment, including coverage of transport;
Facilitating safe deliveries and emergency obstetric and newborn care; and
Removing financial barriers to voluntary family planning and contraceptive access, while ensuring informed choice and avoiding coercion.
Beyond the MISP, CVA also supports the transition to comprehensive SRH services in protracted emergencies and recovery phases. Examples include using cash or vouchers to encourage antenatal and postnatal care, ensure menstrual hygiene, sustain cancer prevention and treatment, fund obstetric fistula repair, and promote SRH education among adolescents.
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Climate Change Toolkit for Health Professionals
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This toolkit consists of eight modules which have been prepared as stand-alone documents that can be read by themselves, but they have also been prepared to complement one another. It has been designed as a tool for health professionals and student
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s in the health care and public health sectors who want to engage more directly on the issue of climate change as educators with their patients, peers and communities, and/or as advocates for the policies, programs and practices needed to mitigate climate change and/or prepare for climate change in their workplaces and communities
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The humanitarian crisis in Northeast Nigeria, driven by conflict, climate-related shocks, and food insecurity, has created immense challenges for the health sector in Borno, Adamawa, and Yobe (BAY) States. About 1.8 million people remain displaced(1
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), with inadequate access to healthcare services and persistent disease outbreaks, malnutrition, and mental health challenges. This strategy outlines a comprehensive localization approach to strengthen the health sector's capacity by empowering local and national actors (L/NAs) include state and local government structures to lead humanitarian responses at respective levels with minimal oversight functions.
The localization strategy aligns with the global commitments of the Grand Bargain 2.0, prioritizing equitable partnerships, capacity sharing, and resource mobilization to enhance sustainable, community-owned health systems(2). Key components include increasing the visibility and meaningful participation of L/NAs in health sector coordination, promoting direct funding to local actors, and addressing systemic barriers such as governance, leadership, capacity, and resource gaps.
The global humanitarian community made a commitment, as reflected in the Grand Bargain 2.0, to localization (3) to improve the efficiency and effectiveness of humanitarian aid. A key priority of this commitment is to empower local actors to take a leading role in delivering assistance, ultimately leading to better outcomes for affected communities. A localized health response, strengthened by partnerships, can achieve several key outcomes, including rapid response and access, community acceptance, cost-effectiveness, links to long-term development, and increased accountability to the community. Localization in health matters because it ensures sustainable and community-owned health responses.
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This publications outlines the specific reproductive health needs of this cadre of adolescents and the programmatic responses that can be used to reach them.
