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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Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how the...y view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
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The Ghanaian Cabinet approved the antimicrobial resistance (AMR)Policy and Implementation plan(hereafter referred to as the national action plan or NAP)in December 2017, whilst the country case study was in progress. This has set in motion the implementation phase for Ghana, which is a long awaited... event since the drafting of the Policy started in 2011. This case study, whilst limited in its ability to interact with all stakeholders, has identified entrypoints within the operational divisions of Ghana Health Services,as potential areas where the AMR policy platform may seek to embed AMR activities. Much work has already been done within Ghana to identify the key entrypoints within the various ministries and government agencieswhere AMR can be incorporated. These stakeholders already form part of the AMR Policy Platform which is the governance structure for AMR and have been participating actively in the development of the AMR Policy and NAP activities formulation.
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The survey is representative of the Union Territory, its states and regions and urban and rural areas. It was conducted in all the districts and in 296 of the 330 townships of Myanmar. A total of 13,730 households were interviewed. It collects data on the occupations of people, how much income they ...earn, and how they use this to meet the food, housing, health, education and other needs of their families. The main focus of the survey is to produce estimates of poverty and living conditions, to provide core data inputs into the System of National Accounts and the Consumer Price Index and to support monitoring of the Sustainable Development Goals.
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Staying safe in spite of a disaster. What can you do for your safety in the event of a disaster?
In spring 2013, after weeks of rain, whole areas of southern, eastern and northern Germany were beset by catastrophic floods. Settlements vanished in th...e floods up to the roofs of the houses, tens of thousands of emergency personnel and volunteers struggled against the water with sandbags. Villages and parts of towns had to be evacuated, and the citizens were only able to take the essentials with them.
Disasters are part of life. Almost every day, we can read about disasters and largescale emergencies in a variety of media and see the images of destruction and suffering. These are not just major disasters which affect large areas for a long time. Local torrential rain, a severe storm, an electric power breakdown resulting from such a storm, or a house fire can trigger a very personal disaster for each individual, each family, which has to be overcome. Take the time to contemplate your personal emergency planning.
This brochure aims to help you to develop your personal preparedness plan.
The brochure is also available in different languages: https://www.bbk.bund.de/DE/Service/Publikationen/Broschürenfaltblätter/Ratgeber_node.html
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Cartes de Counseling, 3ème ed.
The Fourth National Climate Assessment (NCA4) fulfills that mandate in two volumes. This report, Volume II, draws on the foundational science described in Volume I, the Climate Science Special Report (CSSR).2 Volume II focuses on the human welfare, societal, and environmental elements of climate cha...nge and variability for 10 regions and 18 national topics, with particular attention paid to observed and projected risks, impacts, consideration of risk reduction, and implications under different mitigation pathways. Where possible, NCA4 Volume II provides examples of actions underway in communities across the United States to reduce the risks associated with climate change, increase resilience, and improve livelihoods.
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Lack of Access to Reproductive Healthcare in Sudan’s Rebel-Held Southern Kordofan
This manual is designed to help you:
Understand what schizophrenia is and the problems it causes - this is covered in Section A
Learn how to help people schizophrenia and their families through CBR - this is covered in Section B
Know how you will be supported to deliver CBR - this is ...covered in Section C
Throughout the manual you will follow the experiences of Yosef and Sara, people with schizophrenia, and their families. Yosef and Sara are not real people, but their stories include situations and events that real people with schizophrenia have experienced.
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PLoS Med. 2009 Oct;6(10):e1000159. doi: 10.1371/journal.pmed.1000159. Epub 2009 Oct 6.
International Development vol. 11. DOI 10.4073/csr.2015.15
Conférence internationale sur les soins de santé primaires d’Alma-Ata à la couverture sanitaire universelle et aux objectifs de développement durable , Astana, Kazakhstan, 25 et 26 octobre 2018
The EU Facility has a total budget of €6 billion for humanitarian and development actions: €3 billion for 2016-2017 and €3 billion for 2018-20191. Both tranches combined, all operational funds have been committed, €4.7 billion contracted and more than €3.4 billion disbursed. The operationa...l funds for the Facility for 2016-2017 have also been fully contracted2, out of which €2.59 billion has been disbursed. For 2018-2019, €1.76 billion has been contracted, out of which more than €900 million disbursed.
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This study aimed to estimate the cost-effectiveness of a community-based rehabilitation (CBR) programme known as Inspire2Care (I2C), implemented in Nepal by Karuna Foundation Nepal. In the absence of any gold standard methodology to measure cost-effectiveness, the authors developed a new methodology... to estimate the programme’s achievements and cost-effectiveness.
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Le trouble anxiété de séparation (TAS) représente environ la moitié de l’ensemble des troubles anxieux
(Cartwright-Harton et al, 2006). La plupart des troubles anxieux pédiatriques
présentent les mêmes critères diagnostics que chez l’adulte à l’exception du TAS,
actuellement class...é dans le DSM et la CIM au sein des troubles habituellement
diagnostiqués dans la prime enfance, l’enfance ou l’adolescence (Krain et al, 2007).
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