Примеры надлежащей практики в области укрепления систем здравоохранения с целью профилактики и лечения туберкулеза и лекарственно-устойчивого туберкулеза
This casebook collects 64 case studies, each of which raises an important and difficult ethical issue connected with planning, reviewing, or conducting health-related research. The book’s purpose is to contribute to thoughtful analysis of these issues by researchers and members of research ethics ...committees (RECs, known in some places as ethical review committees or institutional review boards), particularly those involved with studies that are conducted or sponsored internationally.
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Supply of essential medicines and health technologies (6 April 2020)
This paper is one of a set of technical guidance papers developed by the WHO Regional Office for Europe to provide practical information and resources for decision-makers on measures to strengthen the health system response to C...OVID-19.
The purpose of this paper is to provide WHO Regional Office for Europe Country Offices and Member States with guidance on how to maintain supplies of medicines and health technologies, including devices, diagnostics and blood products, during the COVID-19 outbreak.
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Internally displaced persons (IDPs), refugees, migrants and returnees constitute a sizeable population in the WHO Eastern Mediterranean Region. There were 12 million refugees (half are Palestinians) and 13 million IDPs in the Region as of 2018. These populations are often vul...nerable to poor health due to the conditions they live in and limited access to needed quality health care. In addition, those who can access care, are often faced with financial hardship. There are also 46 million professionals and low-income labour migrants in the Region (of which 22 million are from the Region), with differential access to health services and varied health coverage schemes
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The framework responds to the demand from Member States and partners for guidance on how the health sector and its operational basis in health systems can systematically and effectively address the challenges increasingly presented by climate variability and change. This framework has been designed ...in light of the increasing evidence of climate change and its associated health risks (1); global, regional and national policy mandates to protect population health (2); and a rapidly emerging body of practical experience in building health resilience to climate change (3).
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Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such
communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now ...COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
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Call to action by the Global Leaders Group on Antimicrobial Resistance on reducing antimicrobial discharges from food systems, manufacturing facilities and human health systems into the environment.
Compared with other health areas, the mental health impacts of climate change have received less research attention. The literature on climate change and mental health is growing rapidly but is characterised by several limitations and research gaps. In a field where the need for designing evidence-b...ased adaptation strategies is urgent, and research gaps are vast, implementing a broad, all-encompassing research agenda will require some strategic focus.
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Despite the continuing war in Ukraine, the Government is preparing for the country’s recovery and reconstruction. Given the magnitude of the attacks on the health infrastructure and consequent disruption to health system functioning, reconstruction of the health system is integral to the country...s recovery. The immediate priorities are to restore essential services, respond to new physical and mental health needs, protect public health, and provide a secure and attractive environment for the return of both health professionals and the general population. This policy note identifies strategic directions for post-war health system recovery in the short and longer terms, while sustaining essential health services during the ongoing invasion
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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 implementing programmes of technical cooperation with the Government of Liberia from January to December 2022. T...he key achievements are summarized under the thematic areas of Universal Health Coverage, Health Emergencies and Corporate and Enabling Support.
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