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Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
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
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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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This guide assumes the reader already has a general understanding of the Care Group methodology. It is highly recommended that all Care Group implementers familiarize themselves with the contents of theCare Groups: A Training Manual for Program Design and Implementation,and, ideally,to participate i
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n an in-person training on Care Groups, before commencing Care Group activities. This guide is meant to serve as a companion to the Care Group Training Manual; and additional details on all topics covered in this guide are provided in the Training Manual. This guide may also be used by program evaluators, as a means to assess the extent to which Care Groups were implemented in accordance with theevidence-based model and their potential contribution to program outcomes.
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Community-based interventions are vital for facilitating poststroke recovery, increasing community participation, and raising awareness about stroke survivors. To optimize recovery and community reintegration, there is a need to understand research findings on community-based interventions that focu
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s on stroke survivors and their caregivers. Although nurses and community health workers (CHWs) are commonly involved in community-based interventions, less is known about their roles relative to other poststroke rehabilitation professionals (physical therapists, occupational therapists, and speech-language pathologists). Thus, the purpose of this review is to explore research focused on improving community-based stroke recovery for adult stroke survivors, caregivers, or both when delivered by nurses or CHWs.
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Almost two years after the signing of the Political Accord for Peace and Reconciliation (APPR), the Central African population is still hostage to an unstable and unpredictable security environment. Continuing conflicts in several areas of the country, structural weaknesses combined with the socio-e
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conomic effects of the COVID-19 pandemic, and the devastating effects of natural disasters have plunged 2.6 million people into dire needs. Of this total, 1.6 million have severe humanitarian needs, a figure unmatched for five years, reflecting a deterioration in the physical and mental well-being and living conditions of populations across the country.
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The State of the world’s nursing 2020 report provides the latest, most up-to-date evidence on and policy options for the global nursing workforce.
Operating Department Practice - Clinical Pocket Reference - for nurses, students and other healthcare professionals - third edition,
supplemantary material Available from
www.clinicalpocketreference.com
ISBN: 978 1 908725 10 3
This guidance document provides basic principles for a spokesperson of any health authority on how to respond to vocal vaccine deniers. The suggestions are based on psychological research on persuasion, on research in public health, communication studies and on WHO risk communication guidelines.
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
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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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USAID funded/ Primary Health Care Project in Iraq (PHCPI) in cooperation with Iraqi Ministry of Health (MOH) aims to promote Primary Health Care (PHC) services provided by Primary Health Care Clinics (PHCCs) in Iraq in order to achieve the development goal in enhancing the PHC provision system throu
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gh achieving the following results: First: Enhancing management and operations systems, which support clinical care. Second: Improving the quality of the delivered PHC according to quality standards. Third: Enhancing and expanding local community participation and partnership in PHC. Maintaining the medical & service devices in the hospitals and health clinics besides making them function according to the adapted standard specifications, lead to providing most efficient medical services for people and accomplish the purposes for which they were invented. Maintenance and repair of facilities and infrastructure, and keeping them safe and clean are also of the important approaches for the results referred to in (first) and (second) above. This can be achieved through enhancing and developing facilities, and medical & service devices management. This guideline seeks to develop work mechanism for engineers, technicians and the PHCCs’ facilities and medical & service equipment maintenance workers; clarify the concept of maintenance, its importance and classifications in health area, its planning and implementation, the tasks and duties of other directorates and departments of the Ministry in relation to all kinds of maintenance. Add to that preparing documents and forms, which are used in documenting and monitoring the steps required to be accomplished in the maintenance of PHCCs’ facilities and medical & service equipment, for the equipment to perform the best possible services for people and get their satisfaction.
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Mosby’s Pocket Guide to Nursing Skills and Procedures, eighth edition, is
a practical, portable reference for students and practitioners in the
clinical setting. Grouped alphabetically, 85 commonly performed skills
are presented in a clear, step-by-step format that includes:
■ Purpose for pe
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rforming each skill
■ Guidelines to help students in delegating tasks to assistive
personnel
■ List of equipment required
■ Rationales to explain why specific techniques are used
■ Full-color photographs and drawings to provide visual
reinforcement
In addition, Safety Alerts are included in the skills to highlight important
information about patient safety and effective performance.
Current Standard Precautions guidelines from the Centers for Disease
Control and Prevention are incorporated throughout. Preprocedure
and postprocedure protocols are conveniently located on the inside
back cover.
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Medicina 2019, 55, 553; doi:10.3390/medicina55090553
Results: Twenty-one studies were analyzed, most of them demonstrating an association between the existence of burnout and the worsening of patient safety. High levels of burnout is more common among physicians and nurses, and it is associated wit
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h external factors such as: high workload, long journeys, and ineffective interpersonal relationships. Good patient safety practices are influenced by organized workflows that generate autonomy for health professionals. Through meta-analysis, we found a relationship between the development of burnout and patient safety actions with a probability of superiority of 66.4%. Conclusion: There is a relationship between high levels of burnout and worsening patient safety.
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Anywhere But Syria: How 10 Years of Conflict Left Syria’s Displaced Children Without a Sense of Home
After ten years of war, the vast majority of Syria’s children cannot imagine a future in their country, according to a new report by Save the Children. On average, 86% of Syrian refugee children surveyed in Jordan, Lebanon, Turkey and the Netherlands said they would not want to return to their cou
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ntry of origin. Of children displaced inside Syria, one in three would rather be living in another country. Children who fled their homes are struggling to feel safe where they are now, as around two in five children of those surveyed by Save the Children said they face discrimination and a lack of education. Many feel they have no say over their future.
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Don’t Leave Them Alone: The future of the cross-border response in north west Syria
ATAA Humanitarian Relief Association, BINAA for Development, Children Of One world, et al.
Save the Children
(2021)
C1
This report, written by ATAA Humanitarian Relief Association, BINAA for Development, Children Of One world, Hand in Hand for Aid and Development, Horan Foundation, Hurras Network, MARAM Foundation, Orange Organization, Syrian American Medical Society, Save the Children and Shafak Organization, provi
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des insights on the humanitarian situation on the ground in north west Syria.
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Factsheet
he WHO South-East Region in 2019 accounted for nearly a million missing TB patients from the estimated incidence. Active case-finding (ACF) or systematic screening for tuberculosis is an important tool to reach out to missing TB patients. When appropriately implemented, the activity is cost effectiv
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e, helps to reduce diagnosis and treatment delays, and prevents the spread of the disease. This document presents an analysis of published ACF studies from the Region. It can be used by Member States for effective planning, implementation and monitoring of these activities.
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Investment in all the drivers and facilitators of hand hygiene action in health care to ensure that it occurs at the point of care and other critical moments requires a multidisciplinary, multifaceted approach. WHO describes such an approach as a “multimodal improvement strategy” (MMIS) which is
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at the core of its implementation models for hand hygiene and infection prevention and control (IPC) programmes. The focus of this document is on the resource considerations for investing in hand hygiene improvement in health care (primary, secondary and tertiary) using the MMIS approach.
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The WHO and UNICEF-led Hand Hygiene for All Initiative aims at ensuring implementation for WHO's global recommendations on hand hygiene to prevent and control COVID-19 pandemic, and hand hygiene improvement sustainability in countries as a mainstay of wider infection prevention and control (IPC) and
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water, sanitation and hygiene (WASH) efforts.
But how can hand hygiene implementation be successful? By implementing strategies and approaches proven through the successes of the WHO Save Lives: Clean Your Hands campaign and fostering integration between hand hygiene and WASH improvements. This brief draws on learning from legacy work and the current evidence based and summarizes how joint action and collaboration are essential for successful strategies, in the context of the COVID-19 response and beyond
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Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them as effective as possible. With this in mind, this manual is
...
intended to be used a practical guide for policymakers and program
managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale. Throughout, we discuss major policy and programmatic issues that decision-makers and planners need to consider when designing, implementing, scaling up or strengthening a national-level CHW program. We offer an overview
of specific challenges CHW programs face, country lessons, tools, and other resources that may be helpful, while incorporating relevant programmatic examples as much as possible.
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New research exposes how women and children are disproportionally affected by climate migration, which puts them at greater risk of gender-based violence, child labour and exploitation.
Governments must ensure the safety and protection of women and girls in climate emergencies, including the safe
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and equal access to basic services, food, and healthcare before, during, and after disasters. Women must also be included in decision making in their communities so they can lead on resilience building and address gendered issues of migration and displacement.
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