Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 110
This report compiles evidence from published, grey literature and key informants on the UNMHCP
since its introduction in Uganda’s health system, and findings were further validated during a oneda...y
national stakeholder meeting.
Three main factors motivated introduction of the UNMHCP. First, Uganda, along with other lowincome countries, was unable to implement holistically the primary healthcare (PHC) concepts as set out in the Alma Ata Declaration. Second, the macro-economic restructuring carried out in the 1990s, which was an international conditionality for low-income countries to access development financing, influenced the trend towards more stringent prioritisation of health interventions as a means of rationing and targeting use of resources. Third, the government sought to achieve equity with a service package that would be universally available for all people.
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Conclusion: To ensure that people with disabilities can successfully access the necessary health services, the barriers on the demand side (the individuals requiring healthcare) as well as the barriers that are part of the healthcare system, should be attended to.
Lessons learnt from the ADCAP programme | This guide shares good practices and challenges that have emerged through the experience of the Age and Disability Capacity Programme (ADCAP) implementing partners, in embedding inclusion of older people and people with disabilities within their humanitaria...n policies and practices. All mainstream and specialist organisations engaged in humanitarian responses can learn and benefit from this experience. This guide complements the ‘Humanitarian inclusion standards for older people and people with disabilities’ (see Appendix 4), by documenting practices that will help humanitarian organisations to systematically include older people and people with disabilities.
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This paper aims to explore the conditions needed for sustainable community based rehabilitation (CBR) programmes for persons with disabilities in Vietnam, and to identify the conditions and opportunities missing at present for the implementation of such programmes.
This study explored family adjustment and access to rehabilitative services for children with Down syndrome, between 0-5 years of age, in the ecoculture of Petchaburi Province, Thailand.
This resource aims to provide relevant and practical guidance to DRR practitioners (policy and programme colleagues), on how to ensure inclusion - particularly of vulnerable groups - in Community-Based DRR (CBDRR) initiatives in Myanmar. It comprises an overall Framework for inclusive CBDRR and a nu...mber of tools/resources including: 1) a checklist for inclusion in the 7 steps of the CBDRR process, 2) a guideline for documenting inclusion, 3) a template for assessing inclusion and 4) a compendium of tools and guidelines relevant to inclusive CBDRR.
The Inclusive Framework and Toolkit for Community-Based DRR in Myanmar is a resource produced by the Myanmar Consortium for Community Resilience (MCCR), a consortium led by ActionAid, with ACF, HelpAge, Oxfam, Plan and UN-Habitat.
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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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The WHO Global Health Estimates show that nearly half a million deaths (493 471) occurred in the WHO European Region due to violence and injuries in 2016. This represents a decline of 29% from 2000. Injuries account for 5.3% of all deaths and 9.6 of all years of life lost. They are a leading cause o...f death in people aged 15–29 years and the second leading cause of death for young people aged 5–14. The three leading causes of injury deaths are self-directed violence (141 089), falls (83 325) and road-traffic injuries (78 198). Inequalities in injury deaths exist in the Region, with mortality rates 2.4 times higher in males than in females and 1.5 times higher in middle-income compared to high-income countries.
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This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and people’s access to and use of them in LMICs, where historic and ongoing under-investments heighten vulnerability to a multiplicity of health threats. We use the term ‘vertical response’ to describ...e decisions, measures and actions taken solely with the purpose of preventing and containing COVID-19, often without adequate consideration of how this affects the wider health system and pre-existing resource constraints.
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This updated step by step guide aims to assist the ministries of health (MoHs) in developing the national action plans for noma prevention and control, with a view to sustainably reducing the incidence of noma as a public health problem through programmes that are fully integrated with national heal...th planning, strengthening of primary health care (PHC) and attainment of universal health coverage (UHC).
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Noma (cancrum oris) is a severe gangrenous disease of the mouth and face. It mostly affects children between the ages of 2 and 6 years living in extreme poverty. In addition to the known factors such as malnutrition, lack of vaccination in children and poor oral hygiene, several social and environme...ntal factors such as maternal malnutrition and close spacing of pregnancies that result in offspring with increasingly weakened immune systems are potentially related to the onset of the disease.
The aim of this guide is to assist the ministries of health (MoHs) to identify a general goal to be attained by the end of five years, with a view to sustainably reducing the incidence of noma as a public health problem through programmes that are fully integrated with national health planning, strengthening of primary health care (PHC) and attainment of UHC.
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This companion document to Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030 ("the road map") aims to support a range of stakeholders - including countries in which neglected tropical diseases (NTDs) are endemic, international organi...zations and non-State actors - to achieve the road map targets through a transdisciplinary, cross-cutting One Health approach. Specifically, it provides guidance on the One Health actions needed by major stakeholders and how to support a paradigm shift towards One Health in national NTD programmes. Examples of common One Health challenges and how they can be overcome as well as illustrative cases studies are provided throughout. The companion document was developed through a global consultative process involving stakeholder interviews, interactive workshops, and online public consultation.
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Adapting community-led approaches . Three out of 10 people in urban areas do not use improved sanitation facilities, and one out of 10 people are forced to practise open defecation. Still higher proportions do not have access to safely managed sanitation facilities, where the fecal sludge
is contai...ned and either left in situ or safely emptied, transported, and delivered to a treatment plant.
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Lymphatic filariasis (LF) infection if untreated results in fluid accumulation in the limbs or breasts (lymphedema) or genitalia (hydrocele) that is painful and causes great discomfort. Morbidity management and disability prevention (MMDP) strategies such as surgery for hydrocele, treatment of acute... attacks and management of lymphedema are necessary for the management of the advanced stages of LF. However, very few countries including Zambia, have adequate information on the health beliefs and health seeking behavior of communities living in endemic areas towards MMDP services for LF. This study sought to explore community and health provider perspectives towards MMDP services for LF in a highly endemic region, Luangwa District, Zambia, between February and April 2019.
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