The 2020 Report analyzes global health spending for 190 countries from 2000 to 2018 and provides insights as to the health spending trajectory from the MDG era to the SDG era prior to the crisis of 2020. The report shows that global spending on health continually rose between 2000 and 2018 and reach...ed US$ 8.3 trillion or 10% of global GDP. The data also show that out-of-pocket spending has remained high in low and lower-middle income countries, representing greater than 40% of total health spending in 2018. We also report and summarize the data on expenditures for PHC, as well as by disease and intervention, including for immunization. The report also analyzes the available data on budget allocation in response to the COVID-19 crisis. In addition, we combine World Bank/IMF projections of the macroeconomic and fiscal impact of the crisis with an analysis of the historical determinants of health spending patterns and UHC indicators, and based on this, we draw out the likely implications of 2020 for future health spending, highlighting key policy and monitoring concerns.
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COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under di...fferent epidemiological scenarios.
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In this era, grand challenges lies in biodiversity loss, climate change, and global noncommunicable diseases signify that planet and humanity are in crisis. Scholarly evidence from human and animal kingdom suggest that there is an optimism in planetary health which can provide a unique and novel con...cept where efforts toward survival and remediation can be made. With accurate navigation, the current challenges can be mitigated leading to a new reality, one in which the core value is the well‐being of all. This paper discusses the drivers of planetary health and the role of community health workers (CHWs) in making health‐care system more resilient that can produce multiple benefits to community and overall planetary health. A web‐based international database such as Google, Google Scholar, SCOPUS/MEDLINE/PubMed, and JSTOR was searched relevant to a planetary health framework. The study findings suggest that CHWs can offer health care interventions through environmental health cobenefits across the spectrum of health effects of climate change cause and effects. These actions have been divided into four major categories (i. health care promotion and prevention, ii. health care strengthening, iii. advocacy, and iv. education and research) that CHWs perform through a variety of roles and functions they are engaged in protecting planetary health. CHWs contribute toward achieving sustainable development goals such as planetary health and focus on environment sustainability and well‐being of entire mankind.
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A two-week mission was conducted by WASH and quality UHC technical experts from WHO headquarters and supported by the WHO Ethiopia Country Office (WASH and health systems teams) in July 2016, to understand how change in WASH services and quality improvements have been implemented in Ethiopia at nati...onal, sub-national and facility levels; to document existing activities; and through the “joint lens” of quality UHC and WASH, to identify and seek to address key bottlenecks in specific areas including leadership, policy/financing, monitoring and evaluation, evidence application and facility improvements. Ethiopia has implemented a number of innovative and successful interventions.
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The Urban Health Equity Assessment and Response Tool (Urban HEART) is a user-friendly guide for policy- and decision-makers at national and local levels to: identify and analyse inequities in health between people living in various parts of cities, or belonging to different socioeconomic groups with...in and across cities; facilitate decisions on viable and effective strategies, interventions and actions that should be used to reduce inter- and intra-city health inequities.
Also available in French and Spanish: https://apps.who.int/iris/handle/10665/79060
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The World Health Organization Disability Assessment Schedule (WHODAS 2.0) is a generic assessment instrument developed by WHO to provide a standardized method for measuring health and disability across cultures. It was developed from a comprehensive set of International Classification of Functioning..., Disability and Health (ICF) items that are sufficiently reliable and sensitive to measure the difference made by a given intervention.
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In March 2020 the IASC Reference Group on Mental Health and Psychosocial Support uniting 57 humanitarian organizations as member issued the Interim Briefing Note Addressing Mental Health and Psychosocial Aspects of COVID-19 Outbreak. This document has proven to be very useful in the response and has... till now been translated in 24 languages. It covers a set of recommended activities as well as messages for different target groups.
The current document is an annex to the Interim Briefing Note and is meant to support the MHPSS operational response within the various sectors of humanitarian work. Approaches and interventions to MHPSS are not confined to one sector, but need to be integrated within many existing sectors and clusters.This document contains a wealth of operational information and practical approaches that can be used for humanitarian programming in health, SGBV, community-based protection, nutrition, camp management and camp coordination.
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This operational guidance on MHPSS provides a practical orientation and tools for UNHCR country operations. It covers specific points of good practice to consider when developing MHPSS programming and offers advice on priority issues and practical difficulties, while also providing some background i...nformation and definitions. Since MHPSS is a cross cutting concept this operational guidance is relevant for programming in various sectors, including health, community based protection, education, shelter, nutrition, food security and livelihoods.
The focus of this operational guidance is on refugees and asylum seekers, but it may apply to other persons of concern within UNHCR operations such as stateless persons, internally displaced persons and returnees. The guidance is meant for operations in both camp and non-camp settings, and in both rural and urban settings in low and middle-income countries with a UNHCR presence.
The guidance should be adapted according to different contexts. A standardized format for programme implementation cannot be offered because this depends to a large extent on existing national capacities and local opportunities.
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance implementation of WHO PEN by providing:
• operational guidance on further integrating CVD management
• technical guidance on evaluating the impact of... CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
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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 sustainable
development and health and shifted the Instit...ute’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.
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WHOs Special Initiative for Mental Health has supported the availability of mental health services for more than 40 million more people. Learn about WHOs Special Initiative for Mental Health, which seeks to increase access to quality and affordable care for mental health conditions in 12 countries ...for 100 million more people. The initiative is advancing policies, advocacy and human rights, and scaling-up quality interventions and services for people with mental, neurological and substance use conditions.
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Suicide is largely preventable. Unlike for many other health issues, the tools to significantly reduce the most tragic loss of life by suicide are available. With collective action to acknowledge and address this serious problem, as well as commitment to effective interventions, supported by politic...al will and resources, preventing suicide globally is within reach. Importantly, it is a
national suicide prevention strategy that allows communities to come together, and begin to tackle suicide and the issues specific to their needs without stigmatization.
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The World Health Organization Regional Office for Africa (WHO AFRO), in accordance with recommendations from various WHO committees, has developed three flagship initiatives to support Member States in the African region to prepare for, detect and respond to public health emergencies. They are the r...esult of extensive consultations with more than 30 African government ministers, technical actors, and partners across the continent as well as regional institutions such as the Africa Centres for Disease Control and Prevention (Africa CDC), whose contributions have shaped the priority activities. This report provides the fourth quarterly summary of progress in implementing the flagship initiatives.
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The World Health Organization Regional Office for Africa (WHO AFRO), in accordance with recommendations from various WHO committees, has developed three flagship programmes to support Member States in the African region to prepare for, detect and respond to public health emergencies. They are the re...sult of extensive consultations with more than 30 African government ministers, technical actors, partners across the continent as well as regional institutions such as the Africa Centres for Disease Control and Prevention (Africa CDC), whose contributions have shaped the priority activities. This report provides the second quarterly summary of progress in implementing the flagship programmes.
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This manual was developed based on the recommendations of a global technical consultation on child health in humanitarian emergencies co-organized by WHO and UNICEF at the end of 2003. WHO in collaboration with the Centre for Refugee and Disaster Response, Bloomberg School of Public Health, Johns Ho...pkins University undertook a systematic review in 2004. It demonstrated that existing guidelines, including The Integrated Management of Childhood Illness (IMCI), do not cover all priority conditions in emergencies. The objective of this manual is to provide comprehensive guidance on child care in emergencies.
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In 2009, WHO’s Second International Conference on Buruli Ulcer Control and Research resolved to strengthen the capacity of national laboratories to confirm cases of the disease, but advised that “efforts are still needed to develop simple diagnostic tools usable in the field as well as disabilit...y prevention methods”.
In 2013, WHO and the Foundation for Innovative New Diagnostics convened a meeting of Buruli ulcer experts in Geneva, Switzerland (9) at which two priority unmet needs in diagnosis were identified:
a diagnostic test for early detection of Buruli ulcer in symptomatic patients with sufficient positive predictive value to put patients on appropriate treatment; and
a screening test at the primary health care or community level for symptomatic patients with ulcer
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A ‘how-to’ guide for Neglected Tropical Disease programmes
This toolkit provides step-by-step guidance to NTD programme managers and partners on how to engage and work collaboratively with the WASH community to improve delivery of water, sanitation and hygiene services to underserved population... affected by many neglected tropical diseases. The toolkit is based on real-life programme experience, which users can match to their needs and local context. It includes a series of tools to help build multisectoral partnerships, mobilize resources, and design, implement and evaluate interventions.
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The scale of international migration in the WHO European Region has increased substantially in the last decade. The dynamics of large-scale migration pose specific challenges and opportunities to health systems, and responses will differ from country to country. Strengthening health system responses... is one of the priority areas in the 2016 Strategy and action plan for refugee and migrant health in the WHO European Region. Its agreed actions include the identification and mapping of practices for developing and delivering health services that respond to the needs of refugees, asylum seekers and migrants. This compendium aims to collect and present some of these practices in the form of case studies. Selected in 2016, the case studies reflect experience from different levels of administration in a variety of European countries, and during the different phases of the migration journey.
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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