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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On Zero Discrimination Day and as part of the global movement for equality for women and girls, UNAIDS is highlighting seven areas where discrimination against women and girls persists, raising awareness and calling for change.
The primary audience for this guidance is persons
working directly in vector-borne disease prevention
and control, including programme managers,
researchers and field workers. A brief technical
background is provided for the benefit of persons
without expertise in vector-borne diseases; readers...
working in the field may wish to skip the background
section and begin with the discussion of ethical
issues and values in Chapter 3. The guidance cannot
offer universally applicable answers to the complex
ethical issues raised, nor can it provide a checklist of
issues that are necessarily relevant in all situations.
Rather, its goal is to help readers recognize aspects
of their work that raise significant ethical challenges
and to respond to these challenges in accordance
with internationally accepted values and norms.
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Guide for clinical case management and infection prevention and control during ameasles outbreak. This guide has been developed to reduce the high morbidity and mortality seen in some of the current outbreaks of measles. This short guide outlines practical clinical care interventions and is derived ...from previously published WHO documents.
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Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in certain countries of Asia and Africa. It often affects people with impaired immunity, including people ...living with HIV, among whom the most frequent clinical presentation is disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region. These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIV
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The Lancet DOI: 10.1016/S0140-6736(20)31053-9
Several countries affected by COVID-19, have seen increases in levels of violence occurring in the home, including violence against children, intimate partner violence and violence against older people. Countries also face increasing challenges in maintaining support and care for survivors of violen...ce. This brief compiles key actions that the health sector can undertake within a multisectoral response to prevent or mitigate interpersonal violence based on existing WHO guidance.
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Physical and social distancing measures are associated with limiting contact between people during disease outbreaks. These measures when applied are often enhanced by lockdowns or shutdowns as part of broader risk communication and community engagement strategies to halt the transmission of disease... outbreaks.
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Policy Brief 2 June 2020
The COVID-19 pandemic is a health and human crisis threatening the food security and nutrition of millions of people around the world. Hundreds of millions of people were already suffering from hunger and malnutrition before the virus hit and, unless immediate action is tak...en, we could see a global food emergency. In the longer term, the combined effects of COVID-19 itself, as well as corresponding mitigation measures and the emerging global recession could, without large-scale coordinated action, disrupt the functioning of food systems. Such disruption can result in consequences for health and nutrition of a severity and scale unseen for more than half a century.
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As of 15 May 2020, more than 4 million confirmed cases of COVID-19, including more than 285,000 deaths have been reported to WHO. The risk of severe disease and death has been highest in older people and in persons with underlying noncommunicable diseases (NCDs), such as hypertension, cardiac diseas...e, chronic lung disease and cancer.
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Immunizations are an essential health service that protect susceptible individuals from vaccine-preventable diseases (VPD).2 By providing timely immunizations, individuals and communities remain protected and the likelihood of a VPD outbreak decreases
This publication is available in Arabic, Chines...e, English, French, Russian and Spanish
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Migrants in Central Asia and the Russian Federation, have been among the most severely impacted by the COVID-19 pandemic.
In the short term, IOM aims at providing support to migrants who are stranded in countries of destination. In addition, IOM will focus its efforts on addressing data gaps, enhan...cing national and community preparedness, response and recovery efforts, ensuring that affected people have access to basic services, commodities and protection as well as mitigating the socioeconomic impact of COVID-19.
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The COVID-19 pandemic has brought social and economic crisis that is rapidly exacerbating an ongoing nutrition insecurity in Nigeria.
To contain the spread of the pandemic in Nigeria, the government has put in place a number of measures, one of which is the lockdown in the three states of Lagos, ...Ogun, FCT and lately Kano, which have high COVID-19 confirmed cases. Similarly, several other states have adopted measures, such as movement restriction, in order to curb the spread of the pandemic.
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In April 2020, the UN launched a coordinated global humanitarian response plan (GHRP) to fight COVID-19 in some of the world’s most vulnerable countries and address the needs of the most vulnerable people. This tips sheet provides practical tips to strengthen disability inclusion within the new up...date of COVID-19 Global HRP. The sheet was developed by the Disability Advisory Group for the DFID-UN SBC.
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The following checklist can help hospitals assess and improve their preparedness for responding to a community-wide outbreak of COVID-19. Each hospital will need to adapt this checklist to meet its unique needs and circumstances. This checklist should be used as one of several tools for evaluating c...urrent plans or in developing a comprehensive COVID-19 preparedness plan.
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Kenya is home to 4 million girls and women who have experienced FGM. Overall, 21 per cent of girls and women aged 15 to 49 years have undergone the practice, varying from 98 per cent in the North Eastern region to 1 per cent in the Western region
Interim Guidance 7 March 2020
This document provides technical guidance for government authorities, health workers, and other key stakeholders to guide response to community spread. It will be updated as new information or technical guidance become available. For countries that are already preparin...g or responding, this document can also serve as a checklist to identify any remaining gaps.
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Emerg Infect Dis. 2020 Jul [date cited]. https://doi.org/10.3201/eid2607.200915
Infection control instructions call for use of alcohol-based hand rub solutions to inactivate severe acute respiratory syndrome coronavirus 2. We determined the virucidal activity of World Health Organization–recommen...ded hand rub formulations, at full strength and multiple dilutions, and of the active ingredients. All disinfectants demonstrated efficient virus inactivation.
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