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In 2018 the Astana Declaration reaffirmed a global commitment to PHC as a cornerstone of sustainable health systems for accelerated progress on universal
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health coverage (UHC) (1). The vision for PHC in the 21st century is for a wholeof-government and whole-of-society approach to health that combines: 1) multisectoral policy and action; 2) empowered people and communities; and 3) primary care and essential public health functions as the core of integrated health service. Signatories, including Nigeria, were urged to implement the vision and commitments of the Declaration according to their national contexts. This case study examines Nigeria’s response to COVID-19 from a PHC perspective between March 2020 and mid-2021.
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Access to safe, effective and quality-assured health products and technologies is crucial for achieving universal health
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coverage and primary health care goals. The continued growth of the aging population; increasing burden of noncommunicable diseases; growing burden of mental health issues; climate change; shifting patterns of vector borne diseases, fungal disease and waterborne diseases; antimicrobial resistance; and new infectious hazards create an ongoing need for equitable access to safe, effective and quality-assured health products and technologies, and renewed investments in research and development for innovative health products and technologies.
The coronavirus pandemic exposed the inequalities in access to health products, highlighting the need for longer-term strategies to strengthen access to health products and technologies outside of and in emergency situations. While technological and scientific advances present an opportunity to increase access to health products and technologies, the risk of increasing inequality due to higher prices for new health products and technologies; the persisting problem of substandard and falsified medical products; a lack of skilled workforce in many low- and middle-income countries; and a lack of data for decisionmaking and for measuring progress present significant challenges.
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As the culminating volume in the DCP3 series, volume 9 will provide an overview of DCP3 findings and methods, a summary of messages and substantive lessons to be taken from DCP3, and a further discussion of cross-cutting and synthesizing topics across the first eight volumes. The introductory chapte
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rs (1-3) in this volume take as their starting point the elements of the Essential Packages presented in the overview chapters of each volume. First, the chapter on intersectoral policy priorities for health includes fiscal and intersectoral policies and assembles a subset of the population policies and applies strict criteria for a low-income setting in order to propose a "highest-priority" essential package. Second, the chapter on packages of care and delivery platforms for universal health coverage (UHC) includes health sector interventions, primarily clinical and public health services, and uses the same approach to propose a highest priority package of interventions and policies that meet similar criteria, provides cost estimates, and describes a pathway to UHC.
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The Global Reference List of 100 Core Health Indicators is a standard set of core indicators prioritized by the global community to provide concise information on the health situation and trends, in
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cluding responses at national and global levels.
This second (2018) edition builds on the previous work of the inter-agency working group that was commissioned by global health leaders to reduce reporting burden. The 2018 list of indicators contains modifications and additions to indicators and metadata elements to reflect the recommended health and health-related indicators of the Sustainable Development Goals, including universal health coverage.
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Policy Note #3: Myanmar Health Systems in Transition Policy Notes Series
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban ar ... eas. For the vast majority of Myanmar’s people, particularly the 70% who reside in rural areas, the township health system (THS) is the only government-funded source of preventive, promotive and curative services.
To achieve the national policy objective of progressing towards universal health coverage (UHC) through a primary health-care approach by 2030, the THS is critical to success. It is responsible for the bulk of health care delivery – particularly in rural areas – and is at the heart of national health development in Myanmar. However, if the THS is to be the backbone of health care provision, it currently suffers from a severe case of osteoporosis. more
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban ar ... eas. For the vast majority of Myanmar’s people, particularly the 70% who reside in rural areas, the township health system (THS) is the only government-funded source of preventive, promotive and curative services.
To achieve the national policy objective of progressing towards universal health coverage (UHC) through a primary health-care approach by 2030, the THS is critical to success. It is responsible for the bulk of health care delivery – particularly in rural areas – and is at the heart of national health development in Myanmar. However, if the THS is to be the backbone of health care provision, it currently suffers from a severe case of osteoporosis. more
Primary health care, as outlined in the 1978 Declaration of Alma-Ata and again 40 years later in the 2018 WHO/UNICEF document A vision for primary health care in the 21st century: towards
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universal health coverage and the Sustainable Development Goals, is a whole-of-government and whole-of-society approach to health that combines the following three components: multisectoral policy and action; empowered people and communities; and primary care and essential public health functions as the core of integrated health services.(1) Primary health care-oriented health systems are health systems organized and operated so as to make the right to the highest attainable level of health the main goal, while maximizing equity and solidarity. They are composed of a core set of structural and functional elements that support achieving universal coverage and access to services that are acceptable to the population and that are equity enhancing. The term “primary care” refers to a key process in the health system that supports first-contact, accessible, continued, comprehensive and coordinated patient-focused care.
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As the global community aims to fulfill its commitments to the UN Sustainable Development Goals, and the achievement of universal health coverage,
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dozens of countries have committed to the expansion of community health workers (CHWs) as the front line of their healthcare systems [1, 2]. Robust research demonstrates CHWs improve access to care, reduce maternal, newborn, and child mortality, improve clinical outcomes for chronic diseases, and prevent disease outbreaks [3].
To support the operationalization of quality CHW program design and implementation, USAID, UNICEF, the Community Health Impact Coalition, and Initiatives Inc. have updated and adapted the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Program Functionality Matrix [12]. This tool can be used to identify design and implementation gaps in both small- and national-scale CHW programs, and close gaps in policy and practice.
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Health systems the world over have embraced the value of community health workers (CHWs) in extending essential services to the community level, improving
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health equity and progressing toward universal health coverage. Governments now have an opportunity to institutionalize CHW programs and professionalize this essential cadre of the health workforce. What will it take to ensure CHW programs, at scale, can achieve their full potential?
Fortunately, policymakers, funders, NGOs, and other partners seeking to design, revamp, or strengthen CHW programs have a suite of tools at their disposal. One of the longest-standing and most rigorously field-tested of these tools is the Community Health Worker Assessment and Improvement Matrix (CHW AIM), an assessment tool which can be used to design, evaluate and strengthen CHW programs.
You can find this assessment tool on this page here. The matrix is also downloaded on MEDBOX, but if you want, you can register for free and get the matrix. After that follow the points underneath.
accessed 23.07.2021
also available in [Français] [Español]
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Implementation of the CHWs guidelines using Amref Health Africa lessons learnt
focuses on providing CHWs with predictable financial and non financial incentives,
frequent support supervision, continuous training and embedding them in
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health
systems with clear roles.
Empowering CHWs represents a cost effective approach with a critical change to-
wards achieving universal health coverage.
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Providing financial protection to the population for larger health care expenses arising out of hospital-based care, has come forth as a crucial element in the attainment of Universal
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Health Coverage (UHC) through the recent health financing reforms of low-and middle-income countries (LMIC). Over the last decade, the state of Assam in India, in an effort to ensure equitable health care access, has formulated multiple health protection schemes at different points of time. This has resulted in several such schemas which have had their own objectives, designs, institutional setups, and governance mechanisms. Moreover, they have reportedly been operating in relative silos.
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Access to health workers who are fit for purpose, motivated and protected is a fundamental force of health service delivery and the achievement of univers
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al health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future development needs of the health workforce can mean the difference between enabling or impeding health systems performance, inclusive economic growth and global health security preparedness and response
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Today, patient harm due to unsafe care is a large and growing global public health challenge and is one of the
leading causes of death and disability worldwide. Most of this patient harm is avoidable. As countries strive to
achieve
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universal health coverage and the Sustainable Development Goals, the beneficial effects of improved
access to health services can be undermined by unsafe care. Patient safety incidents can cause death and
disability, and suffering for victims and their families. The financial and economic costs of safety lapses are high.
There is often reduced public confidence and trust in local health systems when such incidents are publicized.
Health workers involved in serious incidents involving death or serious harm to a patient can also suffer lasting
psychological harm and deep-seated feelings of guilt and self-criticism.
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Rebuilding Liberia’s health system is crucial for improving the country’s overall health outcomes. This annual report highlights key achievements, challenges,and lessons learned in implementi
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ng programmes of technical cooperation with the Government of Liberia from January to December 2022. The key achievements are summarized under the thematic areas of Universal Health Coverage, Health Emergencies and Corporate and Enabling Support.
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Jordan has more than 3 million migrants (one third of the country's total population) and has witnessed three major waves of refugees in its modern history: Palestinians (1948 and 1967), Iraqis (1990 and 2000) and Syrians (since 2010). Under its commitment to achieving
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universal health coverage (UHC), Jordan has been continually supporting vulnerable populations such as refugees and migrants by offering subsidized access to essential health services.
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Background
The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive
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health service delivery towards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published.
Methods
We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. We developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. We considered four service delivery platforms, and modelled two scenarios with differing levels of ambition: a progress scenario, in which countries’ advancement towards global targets is constrained by their health system’s assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. We estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. We projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability.
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Hum Resour Health 20, 37 (2022). https://doi.org/10.1186/s12960-022-00735-y.
For countries to achieve universal health
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coverage, they need to have well-functioning and resilient health systems. Achieving this requires a sufficient number of qualified health workers and this necessitates the importance of investments in producing and regulating health workers. It is projected that by 2030, Africa would need additional 6.1 million doctors, nurses, and midwives. However, based on the current trajectory, only 3.1 million would be trained and ready for service delivery. To reduce current shortages of the health workforce, Africa needs to educate and train 3.0 million additional health workers by 2030. This study was conducted to describe the distribution and ownership of the health training institutions, production of health workers, and the availability of accreditation mechanisms for training programmes in the WHO African Region.
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The Sustainable Development Goals (SDG) 3 and SDG 6 reinforce the need to ensure adequate WASH services, which will result in a reduction in maternal mortality, ending preventable newborn deaths, and providing quality universal
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health coverage. The rationale of the WASH guidelines is to document procedures and provide a framework for strategic planning, implementation of functional and effective WASH services in healthcare facilities in Uganda. These guidelines offer a basis for creating the minimum conditions required for providing healthcare services in a healthy environment for healthcare workers, patients and visitors to the healthcare premises. They also serve as a tool for monitoring the performance of WASH in health care facilities.
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This updated Comprehensive Mental Health Action Plan 2013-2030 builds upon its predecessor and sets out clear actions for Member States, the WHO Secretariat and international, regional and national partners to promote mental
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health and well-being for all, to prevent mental health conditions for those at-risk and to achieve universal coverage for mental health services. While the updated action plan includes new and updated indicators and implementation options, the original four major objectives remain unchanged: more effective leadership and governance for mental health; the provision of comprehensive, integrated mental health and social care services in community-based settings; implementation of strategies for promotion and prevention; and strengthened information systems, evidence and research.
In English, French, Spanish, Arabic and Russian available
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This Community Health Systems (CHS) Catalog country profile is the 2016 update of a landscape
assessment that was originally conducted by the Advancing Partners & Communities (APC) project
in 2014. The CHS Catalog focuses on 25 countries deemed pr
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iority by the United States Agency for
International Development’s (USAID) Office of Population and Reproductive Health, and includes
specific attention to family planning (FP), a core focus of the APC project.
The update comes as many countries are investing in efforts to support the Sustainable Development
Goals and to achieve universal health coverage while modifying policies and strategies to better align
and scale up their community health systems.
The purpose of the CHS Catalog is to provide the most up-to-date information available on community
health systems based on existing policies and related documentation in the 25 countries. Hence, it does
not necessarily capture the realities of policy implementation or service delivery on the ground. APC
has made efforts to standardize the information across country profiles, however, content between
countries may vary due to the availability and quality of the data obtained from policy documents.
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Despite the considerable improvement in global health, millions of people still lack access to quality health services, including access to effective antimicrobial medicines, or are impoverished as
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a result of health spending. At the same time, antimicrobial resistance – a consequence of overuse and misuse of antimicrobials – is increasingly a barrier to accessing effective care. The declining effectiveness of antibiotics is driven by multiple factors, many of which can be addressed through well functioning primary health care. However, primary health care has not always had much attention in national health sector responses to
antimicrobial resistance, which often focus on tertiary care, laboratory detection and surveillance. The three pillars of primary health care (community engagement, front-line health services including primary care and essential public health, and multisectoral action on wider health determinants) are central not just to Universal Health Coverage and the Sustainable Development Goals, but also to an effective response to antimicrobial resistance.
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