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, followed by first and second level hospitals at distric...t 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.
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Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report says. In high-income countries, that rate is 3 deaths per 1,000. Newborns from the riskiest places to give birth are up to 50 times more likely to die than those from the safest places.
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The report also notes that 8 of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. If every country brought its newborn mortality rate down to the high-income average by 2030, 16 million lives could be saved.
More than 80 per cent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, the report says. These deaths can be prevented with access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition.
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2nd edition.
T The Compendium has been developed as a clear and concise instrument to facilitate the understanding and planning of delivery of high-quality care for everybody affected by TB. It incorporates all recent policy guidance from WHO; follows the care pathway of persons with signs or sympt...oms of TB in seeking diagnosis, treatment and care; and includes key algorithms and cross-cutting elements that are essential to a patient-centered approach in the cascade of TB care.
The Compendium is structured into 33 WHO standards and consolidates all current WHO TB policy recommendations into a single resource, with electronic links to the individual, comprehensive WHO policy guidelines
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This report is primarily intended for the community of policymakers and researchers concerned about the rising risks of domestic, regional, and global infectious disease epidemics, and the collective failure to take the coordinated actions required to reduce such risks. These risks include the expec...ted health, economic, and societal costs that are borne by countries, regions, and even all nations in the case of pandemics (which are worldwide epidemics). These risks also include the consequences of increasing antimicrobial resistance (AMR) and its spread within regions and globally. A necessary first step is to monitor whether a broad range of stakeholders are acting to prevent outbreaks from becoming epidemics, whether their capacities to respond to epidemics are robust, and whether preparedness to respond to pandemics and limit the resulting economic and health damage is improving. Analyzing the adequacy of these efforts is vitally important for the decisions of policymakers to invest in the public health and disaster-risk management capacities. Early and effective control of disease outbreaks prevents substantial health and economic costs whether or not the disease can spread globally and become a pandemic.
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The articles in this compendium elaborate on some of the ideas shared at the symposium. Together, they provide a broad view of the dynamic interactions among physical, sexual and brain development that take place during adolescence. They highlight some of the risks to optimal development – includi...ng toxic stress, which can interfere with the formation of brain connections, and other vulnerabilities unique to the onset of puberty and independence. They also point to the opportunities for developing interventions that can build on earlier investments in child development – consolidating gains and even offsetting the effects of deficits and traumas experienced earlier in childhood.
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The Ministry of Health has developed the first version of the Service Standards and Service Delivery Standards for the health sector in Uganda. The main objective is to provide a common understanding of what is expected by the public, service users and service providers in ensuring provision of cons...istently high quality service delivery. These standards also provide a roadmap for improving the quality, safety and reliability of healthcare in Uganda.
The application of these standards is expected to improve transparency and accountability in service delivery; fairness and equity in service provision; building a culture of quality management; regulation, management and control of public and private providers; and management of expectations of service recipients.
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The report aims to help policy-makers and programme managers identify the areas that need attention and to work towards effective implementation and enforcement of policies and legislations. The need for alcohol policy-specific infrastructures to support the alcohol policy process, including designa...ted responsible agency, policy and strategy, and law and regulation, is also required at the country level.
The report is presented in three sections. Section 1 gives an insight to the alcohol consumption situation in the WHO South-East Asia Region and cites the alcohol-related problems that the Region is facing. Section 2 illustrates the policy situation in the 10 areas of national action identified in the Global Strategy to Reduce the Harmful Use of Alcohol and gives specific recommendations pertaining to these areas. Section 3 provides overall recommendations.
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India contributes to 16% of the global maternal deaths and around 27% of global newborn deaths. Reducing the burden of maternal and newborn mortality and morbidity in urban poor settings today requires an expansion of effective Maternal and Newborn Health (MNH) care services and lowering the barrier...s to the use of such services, especially availability and accessibility.
For designing sensitive, responsive and relevant urban health policy and action, it is important for planners and programme managers to understand the context with regard to current systems and mechanisms, potential organisations and best practices.
In order to adres this need, Save the Children’s Saving Newborn Lives programme commissioned a study that reviewed the literature and looked at available secondary data on MNH in urban poor settings.
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Review of International, Regional and National Policies and Legal Frameworks that Promote Migrants and Mobile Populations' Access to Health and Malaria Services in the Greater Mekong Subregion (Cambodia, Lao People's Democratic Republic, Myanmar, Thailand and Viet Nam)
Migrants and mobile popul...ations face many obstacles in accessing equitable essential health care services due to factors such as living and working conditions, education level, gender, irregular migration status, language and cultural barriers, anti-migrant sentiments, and lack of migrant-inclusive health policies among others. Despite significant progress having been made in the context of malaria control in the Greater Mekong Subregion (GMS), human movements can impact malaria transmission patterns and potentially introduce drug-resistant parasites. This legal framework review therefore serves as a guidance document on approaches to address malaria and malaria elimination for migrant and mobile populations (MMPs) in five countries of the GMS.
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Based on WHO South-East Asia Regional Strategy on Autism Spectrum Disorder
The collaborative framework for implementation of the “WHO South-East Asia Regional Strategy on Autism Spectrum Disorders” articulates to Member States: the nature of autism spectrum disorder and the issues faced by ...PwASD and their caregivers; the foundation on which the Regional Strategy and the collaborative framework is based; desired outcomes against each objective of the ASD Regional Strategy; recommended actions to fulfill each objective; requisite parameters that should govern the recommended actions; and suggested guidelines for monitoring, evaluating and reporting a Member State’s progress towards fulfilling the objectives. It encourages Member States to share best practices and information for promoting cooperation and partnerships for development of effective and sustainable programmes.
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The Road Map outlines various strategies which will guide policy makers, development partners, training institutions and service providers in supporting Government efforts towards the attainment of MDGs related to maternal and neonatal health.
This publication outlines public health aspects of alcohol use and harm in WHO South East Asia Region Countries. It summarizes Global Regional and country specific data and also discusses aspects of alcohol control that are important in the context of the Region. The possible future trend of alcohol... use in the Region is also analysed and current and future barriers to effective alcohol control in countries of the Region are discussed.
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In 2014, the Ministry of Health (MOH) in Malawi conducted a nationwide assessment of emergency obstetric and newborn care (EmONC) services. This cross-sectional facility-based survey used 10 data collection modules. Data collection began on 23rd September 2014 and concluded on 17th October 2014, in ...all 28 districts. Facilities in both the public and private sector (for-profit and not-for-profit) were included. Since the focus of the assessment was obstetric and newborn care, health facilities that did not offer maternal and newborn health (MNH) services were not selected. In all districts, a census of all hospitals and a 60 percent random sample of health centres that ought to have performed deliveries in the previous year yielded a total of 365 facilities: 87 hospitals and 278 health centres. All these facilities were visited during the assessment. During analysis, weighting procedures were applied to extrapolate results to the district and national level, representing all 87 hospitals and 464 health centres. Such weighting was necessary as a stratified random sample of health centres was taken and weighting applied to all indicators and presentations that have health facility as a unit of measurement. Case reviews and provider’s interviews, on the other hand, are not weighted as their sampling strategy is based on convenience.
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The Report describes the evaluation of WHO's contribution to the Maternal Health Program in South-East Asia Region. This was an independent evaluation conducted in 2015 by Amaltas, a Delhi based organization. The evaluation highlights the progress in five countries, namely Bangladesh, Indonesia, Mya...nmar, Nepal and Sri Lanka and provides specific recommendations for Organizational Learning and Development. This report will be useful for all those interested in WHO's work on Maternal Health Program in the Region.
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This case study examines the humanitarian response to the conflict-related crisis in the North-East of Nigeria, focusing primarily on the period from 2015 to the end of 2016. The aim is test the central hypotheses of the Emergency Gap project: that the current structure, conceptual underpinning and... prevalent mindset of the international humanitarian system limits its capacity to be effective in response to conflict-related emergencies.
As with many conflict-related crises, the emergency in north-east Nigeria has deep and complex roots in the history of the region. The conflict began in 2009 and quickly developed beyond the control of the authorities. It unfolded in the midst of pre-existing political, social and economic tensions, making an effective humanitarian response exceedingly difficult. Despite this complexity, what is clear is that the crisis has resulted in a sprawling humanitarian disaster that has killed over 25,000 people as a direct result of the violence, and continues to devastate many more lives through hunger, psychological trauma and lack of access to healthcare.
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At the threshold of Sustainable Development Goals (SDG) era, this document captures the remarkable achievements by Member States towards achieving MDGs 4 and 5. It acknowledges new opportunities in the post-2015 phase shaped by the SDGs and the Global Strategy for women’s, children’s and adoles...cents’ health and presents an advanced state of preparedness in the Region. This also highlights the region’s renewed commitment for a more inclusive and more dynamic flagship action for ending preventable maternal, newborn and child mortality as well as to improve women’s, children’s and adolescents’ health and wellbeing in the South-East Asia Region.
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Oral diseases are among the most common chronic diseases worldwide and constitute a major public health problem due to the huge health and economic burden on individuals, families, societies, and health care systems. The recent emphasis on the role of determinants of health, common risk factors and ...their recognition in the context of the growing burden of noncommunicable diseases (NCDs) provides good opportunities for integrating oral health into NCD prevention and control efforts. This Strategy for oral health in South-East Asia, 2013-2020, presents guidance to Member States in developing national policy and action plans to improve oral health within existing socioeconomic, cultural, political and health system contexts. It expresses the consensus on major strategies in the area of oral health promotion as well as oral disease prevention and control for the South-East Asia Region aiming at reducing the health and socioeconomic burden resulting from oral diseases, reducing oral health inequities, and improving the quality of life of the population.
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This publication provides directions for a logical, evidence informed approach to selecting, developing, implementing and monitoring population-based interventions within the context of the double-burden of malnutrition in South-East Asia. The focus of this guide is on processed or ultra-processed p...re-packaged foods.
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Nepal has made substantial progress in reducing under-five mortality and is on track to achieve Millennium Development Goal 4, but advances in neonatal health are less encouraging. The objectives of this study were to assess relative and absolute inequalities in neonatal mortality over time, and to ...review experience with major programs to promote neonatal health.
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