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A case study of the role of an Essential Health Benefit in the delivery of integrated health services in Zambia
Luwabelwa, M.; Banda, P; Palale M.; Chama-Chiliba, C.
Regional Network for Equity in Health in east and southern Africa (EQUINET)
(2017)
C1
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 district 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. more
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 district 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. more
Aims of the CNS programme:
- To provide accessibility to quality nursing care and related services including clinical assessment and personalized care for persons enrolled/entitled to CNS services.
- To enhance the independence and health ... outcomes of entitled persons by avoiding early admission to hospital and/or residential care by providing access to CNS.
- To provide nursing, midwifery and advanced/specialized care through CNS delivered by a skills mix of registered and enrolled nurses.
- To facilitate provision of preventive, promotive and rehabilitative services to the community. more
- To provide accessibility to quality nursing care and related services including clinical assessment and personalized care for persons enrolled/entitled to CNS services.
- To enhance the independence and health ... outcomes of entitled persons by avoiding early admission to hospital and/or residential care by providing access to CNS.
- To provide nursing, midwifery and advanced/specialized care through CNS delivered by a skills mix of registered and enrolled nurses.
- To facilitate provision of preventive, promotive and rehabilitative services to the community. more
One billion people around the world live with disabilities. This report makes the case that they are being “left behind” in the global community’s work on health. This lack of access not only
...
violates the rights of people with disabilities under international law, but UHC and SDG 3 cannot be attained without better health services for the one billion people with disabilities.
more
Needs and barriers for mental health and psychosocial support among syrian refugees in lebanon: perspectives for future interventions
European Union Civil protection and Humanitarian Aid
European Union Civil protection and Humanitarian Aid
(2018)
CC
Results
Recommendations• NGOs should provide MHPSS services with a focus on empowerment and self-reliance
• Introduce interventions focusing on pain mechanisms, coping strategies and physical resilience
• Implement livelihood programmes
• Increase service accessibility and outreach activ
...
ities
• Provide support groups for people who have lost a close family member
• Highlight the importance of supervision and training
• Ensure high quality service provisions by applying relevant outcome measures and to further contribute to the evidence base for MHPSS
• Diversify MHPSS activities to different target groups, including men and women, and address the needs of elderly and individuals with disabilities
This study provides evidence of a large gap between the need of MHPSS among Syrian refugees and provided services. Of the 1082 respondents in this study, 62% expressed that they needed assistance to deal with physical pain and distress. Almost 80% reported being in pain, of which 27% were in severe or very severe pain. Additionally, 55% suffer from distress and 56% rate their own health as fair or poor. Even among the 18-25-yearolds, the prevalence of reporting their overall health as fair was 30.7%. For functionality levels, 28.5% felt severely or extremely emotionally affected by their health problems, and more than 20% had serious difficulties in doing day-to-day work. On the other hand, the majority (72-74%) had no problems in maintaining friendships and participating in community activities
more
Integrated Management of Newborn and Childhood Illness, Part 1 Blended Learning Module for the Health Extension Programme
HEAT, UNICEF, Open University, AMREF, WHO
Ministry of Health, Federal Democratic Republic of Ethiopia
(2011)
C1
These Blended Learning Modules cover the full range of health promotion, disease prevention, basic management and essential treatment protocols to improve and protect the health of rural communities
...
in Ethiopia. A strong focus is on enabling Ethiopia to meet the Millennium Development Goals to reduce maternal mortality by three-quarters and under-5 child mortality by two-thirds by the year 2015. The Modules cover antenatal care, labour and delivery, postnatal care, the integrated management of newborn and childhood illness, communicable diseases (including HIV/AIDS, malaria, TB, leprosy and other common infectious diseases), family planning, adolescent and youth reproductive health, nutrition and food safety, hygiene and environmental health, non-communicable diseases, health education and community mobilisation, and health planning and professional ethics.
more
As a lower-middle-income country (LMIC), South Africa (SA) bears
the burden of maternal and neonatal mortality similar to other sub-
Saharan African countries. According to the Saving Mothers Report
2017/19, there has been a progressive and sustained reduction
in institutional maternal mortality
...
(iMMR) in the past three triennia
(2010-2019), from 320 per 100,000 live births to 120 per 100,000 live
births.
According to the Rapid Mortality Survey, the country’s infant mortality
rate has declined from 29 deaths per 1000 live births in 2014 to 25
deaths per 1,000 live births in 2018. The institutional neonatal death
rate showed a slight decrease from 12,7 deaths per 1,000 live births in
2016 to the current level of 12 per 1,000 live births and has remained
static at this level for the past three years (saDHIS).
Working towards the Sustainable Development Goal (SDG) of reducing maternal mortality to below 70 per 100 000 live births and neonatal mortality to 12 deaths per 1000 live births, South Africa aims to reduce institutional maternal mortality, neonatal mortality and stillbirths by 50% by 2030.
This Maternal, Perinatal and Neonatal Health Policy provides a
framework for the delivery of quality, comprehensive, and integrated
MNH services and will guide the development and review of guidelines
and related MNH interventions, including strengthening of the service
delivery platform, governance, leadership and accountability for
the provision of quality MNH services, development of advocacy
messages, and guiding civil society priorities and community
initiatives. The policy will also guide the development and review of
academic curricula and the setting of research priorities.
more
The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health
...
coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism for achieving universal health coverage, and the PHC approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets.
The PHC approach is defined as a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: (1) primary care and essential public health functions as the core of integrated health services; (2) multisectoral policy and action; and (3) empowered people and communities.
This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV. Specifically, it aims to:
• provide guidance to policy-makers, health system managers and programmatic leads from both PHC and HIV backgrounds regarding opportunities to jointly advance their respective efforts to strengthen PHC and end AIDS as a public health threat; and
• provide a resource for all stakeholders who seek to contribute to strengthening PHC and ending AIDS as a public health threat in a synergistic manner, including people living with HIV, members of key and vulnerable populations, community and civil society representatives, people working in all areas of health systems, researchers, funders and private-sector decision-makers.
more
Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months.
"Around half of children across Eur
...
ope and Central Asia – or 92 million children – are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia.
Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region.
As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to:
- Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans
Invest in heat health action plans and primary health care to more adequately support heat-related illness among children
- Invest in early warning systems, including heat alert systems
- Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress
- Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure
- Secure the provision of safe water, particularly in countries with deteriorating water quality and availability.
UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress.
more
The protracted humanitarian situation in northeastern Nigeria, particularly in Borno, Adamawa, and Yobe (BAY) States, remains a concern due to ongoing insecurity, displacement, food insecurity, disease outbreaks, and climate-related shocks. To address these complex challenges, the
...
health sector has developed a comprehensive humanitarian response strategy aligned with the three States Development plans, Durable Solutions for the Population Displacement Plan, and the Humanitarian Need Response Plan for 2025. This strategy aims to reduce morbidity and mortality among crisisaffected populations by ensuring timely, equitable, and effective delivery of lifesaving health services, while strengthen the resilience of health system and enhancing local and national capacities for sustainable health response in protracted emergency.
Supported by an in-depth analysis of the ongoing health humanitarian response using the Strengths, Weaknesses, Opportunities, and Threats (SWOT) methodology, the strategy is guided by three key objectives:
1. Provide access to lifesaving interventions and sustain an effective response to the prolonged health emergency.
2. Prevent, mitigate, and prepare for health risks from all hazards and respond to all health emergencies.
3. Advance the primary health care approach and essential health system capacities for universal health coverage.
To achieve these objectives, the strategy employs the “Five C” framework which refers to:
• Collaborative Surveillance: Enhancing collaborative efforts for effective monitoring.
• Community Protection: Implementing community-based protection measures.
• Safe and Scalable Care: Ensuring care that is both secure and scalable.
• Access to Countermeasures: Facilitating access to necessary countermeasures.
• Emergency Coordination: Coordinating emergency responses efficiently.
These proactive approaches are designed to be more anticipatory and preemptive rather than reactive, aiming to meet the needs of the crisis-affected population by providing lifesaving interventions, enhancing preventive and anticipatory actions, and ensuring the resilience of the health system. All actions are guided by International Humanitarian Standards and the Humanitarian Principles.
The implementation of the health humanitarian response strategy will involve collaboration with local authorities, non-governmental organizations (NGOs), and international organizations. The strategy emphasizes localization and resource mobilization, efficient logistics and supply chain management, mainstreaming protection, and the deployment and training of healthcare workers. Continuous monitoring and periodic evaluation will ensure the effectiveness of the response. Cross-sector collaboration with sectors such as WASH, Nutrition, Education, and Protection will be crucial to enhance the quality and reach of health interventions. Additionally, sustainability and transition approaches will ensure long-term health outcomes and benefits, bridging the gap from humanitarian to development efforts.
By adopting this comprehensive approach, the humanitarian response in northeastern Nigeria, particularly in BAY States, can be effectively guided, ultimately reducing the suffering of affected populations.
more
As the world population is growing and health care resources are in high demand the pressure on medical services is becoming higher. Developing countries are already at a crisis point in health care
...
provision, and time demands a new approach in structuring medical resources. Primary care is the vital pillar for fundamental health care at community level and has been deemed as a cost-effective modality. In the West the primary care physician manages chronic medical conditions in communities and therefore reduces unnecessary hospital admissions. In the West, the primary care system is extremely well organised. Low-income countries must improve teaching, training and funding in primary care. In this article the urgent need for primary care is discussed in developing countries, and ways to minimise costs and improve clinical outcomes at community level.
more
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
...
), 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.
more
The document "Combating False Information on Vaccines: A Guide for Health Workers" is designed to help health workers address vaccine misinformation. It begins by defining misinformation and explain
...
ing why it spreads rapidly, often due to its emotional appeal and simplistic explanations. The guide identifies common sources of vaccine misinformation, including influential individuals who profit from spreading false information. The document outlines strategies for combating misinformation, emphasizing the importance of health workers as trusted sources. It provides tips for identifying misinformation online, such as checking URLs, dates, and author credentials, and recognizing tactics like evoking strong emotions or pushing conspiracy theories. Two main approaches to fighting misinformation are discussed: prebunking and debunking. Prebunking involves warning individuals about potential misinformation before they encounter it, while debunking aims to correct false information after it has been consumed. The guide offers practical examples for both methods. Additionally, the document highlights the role of health workers in supporting peers and patients to trust immunization. It suggests being kind, nonjudgmental, and transparent when addressing concerns, and using motivational interviewing techniques to understand and respond to patients' doubts. Overall, the guide emphasizes the critical role of health workers in maintaining trust in vaccines and provides comprehensive strategies to identify, address, and prevent the spread of vaccine misinformation in clinical and community settings. The guide is a valuable resource for health workers to enhance their ability to combat vaccine misinformation, support informed decision-making, and promote trust in vaccines within their communities, and it addresses a pressing issue with practical solutions, supports trusted health workers, and ultimately aims to protect public health by promoting accurate information and trust in vaccines.
more
It focuses on nine major priority areas, namely: Leadership and Governance for Health; Health Service Delivery; Human Resources for Health;
...
Health Financing; Health Information Systems; Health Technologies; Community Ownership and Participation; Partnerships for Health Development; and Research for Health.
more
Slum population in India is growing fast (25.1% decadal growth – Census 2011). Its health and nutrition indicators are worse than that of the non slum urban areas and comparable to that of rural India.
The National Urban
...
Health Mission (HUHM), launched in 2013, focuses on improving the health of urban slum population through a needs based, city-specific urban health care system that includes a revamped primary care system, targeted outreach, equitable access, and involvement of the community and urban local bodies (ULBs).
The HUHM recognizes that lack of disaggregated data collected at local and/or city level impedes efficient planning with focus on the urban poor, and that data availability is a critical need.
more
Financing Global Health 2018: Countries and Programs in Transition
Institute for Health Metrics and Evaluation (IHME)
Institute for Health Metrics and Evaluation (IHME)
(2019)
C2
This 10th edition of the Institute for Health Metrics and Evaluation’s annual Financing Global Health report provides the most up-to-date estimates of development assistance for
...
health, domestic spending on health, health spending on two key infectious diseases – malaria and HIV/AIDS – and future scenarios of health spending. Several transitions in global health financing inform this report: the influence of economic development on the composition of health spending; the emergence of other sources of development assistance funds and initiatives; and the increased availability of disease-specific funding data for the global health community. For funders and policymakers with sights on achieving 2030 global health goals, these estimates are of critical importance. They can be used for identifying funding gaps, evaluating the allocation of scarce resources, and comparing funding across time and countries.
more
United for Global Mental Health
(2019)
CC
Working in partnership with international agencies and experts in the field, we exist to support and unite the global effort to promote mental health. We are all passionate about catalysing greater action on mental
...
health and many of us have first-hand experience of living with a condition ourselves.
We provide advocacy, campaigning and financial support to global institutions, businesses, communities and individual changemakers seeking greater action on global mental health.
Do you need mental health support?
Talking about mental health is really important. However it can be difficult for some and can trigger a strong emotional response. United for Global Mental Health is not a provider of mental health support services or guidance. If you feel you need support with your mental health please ensure you seek the appropriate support from your local health care facility, local community group that specialises in mental health or (if available) a national helpline. (Countries: UK; India; Nigeria; South Africa; New Zealand; Australia)
more
As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicro
...
bial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
more
The purpose of this document is to provide ministries (e.g. Ministry of Health (MOH), Ministry of Water (MOW)), sub-national public health authorities, and implementing partners with a practical fra
...
mework of action to both prepare for and mitigate community transmission of COVID-19. The document does not address how to implement the included actions. Parts of this document are relevant for all environments, but the focus is placed on lower-resource settings
more
Communicable Diseases: Part 4 Other Diseases of Public Health Importance and Surveillance.
HEAT, UNICEF, Open University, AMREF
Ministry of Health, Federal Democratic Republic of Ethiopia
(2015)
C1
Blended Learning Modulef or the Health Extension Programme
In this study session, you will learn about the general features of faeco-oraldiseases: the main types commonly found in Ethiopia, their general symptomsand signs, how to treat mild cases a
...
nd when to refer patients with severeconditions for specialised treatment, or laboratory tests to confirm thediagnosis. You will also learn about the importance of giving effective healtheducation to your community on ways to prevent and control faeco-oraldiseases.
more
The world faces grave consequences from the lack of available mental health services and treatment. Mental illness impacts every country, culture and community, with the World
...
Health Organization (WHO) stating that 10% of the global burden of disease is related to mental, neurological and substance use disorders. In low-and middle-income countries, more than 75% of people with mental disorders receive no treatment at all for their disorder. During 2020, as a result of the global pandemic, 93% of countries reported their mental health services were either halted or interrupted (WHO, 2020e). WHO reported a 25% increase in depression and anxiety alone during the pandemic. The Organisation for Economic Co-operation and Development estimates depression and anxiety cost the global economy US $1 trillion dollars a year. All nurses have a health care role in mental health and substance use. ICN strongly advocates for the investment of further education and professional development in this area in order to support individuals and communities achieve the highest attainable standard of health which includes
physical, mental and social wellbeing.
more
