Medical Journal of Zambia, Volume 36 Number 4 (2009)
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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March 2021
This report presents the key findings of the NFHS-5 survey in Goa, followed by detailed tables and an appendix on sampling errors. The 2019-21 National Family Health Survey (NFHS-5), the fifth in the NFHS series, provides information on population, health, and nutrition for India and eac...h state and union territory.
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Handout. Feeling under pressure is a likely experience for you and many of your colleagues. Stress and the feelings associated with it are by no means a reflection that you cannot do your job or that you are weak. Managing your mental health and psychosocial well-being during this time is as import...ant as managing your physical health. This is not a sprint. It is a marathon that requires ongoing self-care.
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Wenn wir den Planeten erhalten wollen, braucht es eine globale Ernährungswende. Ist die "Planetary Health Diet" eine Lösung?
This guidance note identifies strategic action for policy-makers and managers at the national, subnational and facility level to address these different challenges.
Towards a Healthier Botswana
Manual for Trainers and Programme Managers