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South African Health Review 2019
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Sanders, S. Health System Trust HST (2020) C1

22nd edition The purpose of the SAHR has always been to analyse and assess progress and challenges in key areas of the health system, and to propose recommendations for improvement. We are pleased to continue this tradition in the 2019 edition, whi ... more

2 million African community health workers - Harnessing the demographic dividend, ending AIDS and ensuring sustainable health for all in Africa

UNAIDS (2017) CC

This report makes the case for a major new initiative—to rapidly recruit, train and deploy 2 million community health workers in Africa. Drawing on a vast body of evidence and substantial regional experience, the report shows how community ... more

Strengthening the collection, analysis and use of health workforce data and information: a handbook

World Health Organisation (WHO) (2023) C_WHO

Access to health workers who are fit for purpose, motivated and protected is a fundamental force of health service delivery and the achievement of universal ... more

Addressing Inequalities in Global Health: UNU IIGH Strategic Plan 2024–2028

United Nations University UNU (2024) C1

The 2019-2023 Strategy for UNU-IIGH, developed in 2018, built on UNU-IIGH’s strategic advantage and position vis-à-vis the UN and global health ecosystem. The Strategy set a goal to advance evidencebased policy on key issues related to sustain ... able development and health and shifted the Institute’s body of work from investigator-driven global health projects to three priority-driven, policy-relevant pillars of work, each reflecting UNU-IIGH’s unique value position. When the COVID-19 pandemic hit in 2020, the Institute adapted and reprioritised its areas of work while continuing to deliver on the main strategic objectives of translating evidence to policy, generating policy-relevant analyses on gender and health, and strengthening capacity for local decision making especially in the Global South. The new strategic plan encompasses four work packages: 1. Gender Equality and Intersectionality: through this work, we will aim to improve the quality of health care through a human-centred approach, by ensuring the health system is responsive to the needs of structurally excluded individuals and communities; and by advancing a positive and enabling environment for the frontline health workforce—e.g. addressing the experience of gender-based violence. 2. Power and Accountability: through this work, we will catalyse equitable shifts in power and address key accountability deficits that prevent the equitable and effective functioning of the global health system and prevent adequate responsiveness to the needs of states and populations in the Global South. 3. Digital Health Governance: through this work, we will address the colonial legacies and power asymmetries that negatively impact robust digital health governance, identify ways to strengthen health data governance with a particular focus on SRHR and promote diversity in technology design and development. 4. Climate Justice and Determinants of Health: through this work we will leverage UNU-IIGH's position within the UN and network of UNU institutes, network experts, practitioners, policy-makers, and academics to advance evidence-based policy on the different dimensions of the climate emergency and its impact on health. more

Qualitative assessment of community health workers’ perspective on their motivation in community-based primary health care in rural Malawi

Ndambo, M.K.; Munyaneza, F.; Aron, M.B. et al. BMC Health Services Research (2022) CC

Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based primary health care through screening, treatment, referral, psychosocial support, and accompan ... iment. With a broad scope of work, CHW programs must balance the breadth and depth of tasks to maintain CHW motivation for high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to enhance their programmatic activities. Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose. Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal- lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi- tive work environment through supportive relationships between CHWs and supervisors enables the CHWs. Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec- tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance, manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha- sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided to the patients and communities, along with building supportive systems to recognize the work done by CHWs for the primary health care systems. more

Atlas - Child and adolescent mental health resources

World Health Organization; International Association for Child and Adolescent Psychiatry and Allied Professions; World Psychiatric Association (2005) C_WHO

Global concerns: Implications for the future Child Mental Health Atlas

Mental health legislation & human rights

World Health Organization WHO (2003) C_WHO

Health as the pulse of the new urban agenda

World Health Organization WHO (2016) C_WHO

This report considers how to integrate health into urban planning, investments, and policy decisions, so as to support the implementation and achievement of the goals and objectives of the New Urban Agenda.

Antimicrobial stewardship programmes in health-care facilities in low- and middle-income countries. A WHO practical toolkit

World Health Organization WHO (2019) C_WHO

Stewardship is defined as “the careful and responsible management of something entrusted to one’s care”. It was originally applied in the health-care setting as a tool for optimizing antimicrobial use, termed “antimicrob ... more

The link between the West African Ebola outbreak and health systems in Guinea, Liberia and Sierra Leone: a systematic review

Haitham Shoman, Emilie Karafillakis and Salman Rawaf (2017) CC

Shoman et al. Globalization and Health (2017) 13:1 DOI 10.1186/s12992-016-0224-2

Tracking urban health policies

World Health Organisation (WHO) (2023) C_WHO

To enhance health co-benefits across urban policies which tackle air pollution and climate change, WHO, in cooperation with various international, national, and local partners, implemented the Urban Health ... more

Africa’s Health Financing in a New Era

Africa Centres for Disease Control and Prevention (Africa CDC) (2025) CC

Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure o ... n Africa’s already fragile health systems as ODA is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health. In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to 213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance. more

Evaluation of a point-of-care blood test for identification of Ebola virus disease at Ebola holding units, Western Area, Sierra Leone, January to February 2015.

Walker, N.F.; et al. (2015)

Euro Surveill. 2015 Mar 26;20(12). pii: 21073.

Public health risk mapping and capacities assessment in Ghana

Ministry of Health, Ghana, World Health Organizaiotn (WHO) and Ghana Health Service (2016) C1

WHO Competency Framework for Health Workers’ Education and Training on Antimicrobial Resistance

World Health Organization WHO (2018) C_WHO

The framework is to be used as a reference guide, applied according to local priorities and needs, and targeted at academic institutions, educators, accreditation bodies, regulatory agencies and other users. The ultimate aim is to ensure that all health ... more

Developing Global Health Programming

Evert, J.; P. Drain, and T. Hall (2014) CC

A Guidebook for Medical and Professional Schools, Second Edition. This book represents a significant step to engage health professions schools in addressing global health challenges

Global health ethics: key issues

World Health Organization (WHO) (2015) C_WHO

This document aims to assist policy‑makers, health care providers and researchers to understand key concepts in health ethics and to identify basic ethical questions surrounding ... more

Facility Delivery and Postnatal Care Services Use among Mothers Who Attended Four or More Antenatal Care Visits in Ethiopia: Further Analysis of the 2016 Demographic and Health Survey

Abeje Fekadu, G. F. Ambaw Getahun; and S. Ayenalam Kidanie (2018) CC

Demographic and Health Surveys, Working Paper

Health in the green economy : health co-benefits of climate change mitigation - transport sector

World Health Organization (WHO) (2012) C_WHO

The threat climate change poses to health, equity, and development has been rigorously documented. However, in an era marked by economic crisis, regional conflicts, natural disasters and growing disparities between rich and poor, the joint global ac ... more

World mental health report: Transforming mental health for all

World Health Organization WHO (2022) C_WHO

Mental health is critically important to everyone, everywhere. All over the world, mental health needs are high but responses are insufficient and inadequate. The World mental ... more