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Pathways to progress: a multi-level approach to strengthening health systems

Samuels, F., Amaya, A.B., Rodríguez Pose, R. and Balabanova, D. Overseas Development Institute (2014) C1

Findings on maternal and child health in Nepal, Mozambique and Rwanda, and neglected tropical diseases in Cambodia and Sierra Leone | This report synthesises findings from five country case studies from the health dimension of this project, which focus on maternal and child health (MCH) (Mozambique... more

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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 accompaniment. With a broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in 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

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National Strategy For Scale-Up Of Chlorhexidine in Nigeria

Federal Ministry of Health, Nigeria (2016) C2

Building on Nigeria’s Call to Action to Save Newborn Lives, the Federal Ministry of Health (FMoH) has developed the National Strategy and Implementation Plan for Scale-up of Chlorhexidine. The Ministry incorporated existing maternal, newborn, and child health plans with additional comprehensive st... more

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Ghosts in the nursery in exile—Supporting parenting in exile during the COVID‐19 pandemic

L. Schestag; Mehner-Gentner, J.; Stein, L.; et. al. (2021) CC

The early prevention project “Strong together!” supports refugee parents and their young children (0–4 years) in Berlin, Germany. It aims to mitigate the transmission of trauma to the generation born in exile. For refugee families who have only recently arrived in Germany, the COVID‐19 pande... more

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Classification of digital health interventions v1.0. A shared language to describe the uses of digital technology for health

World Health Organization (2018) C_WHO

The classification of digital health interventions (DHIs) categorizes the different ways in which digital and mobile technologies are being used to support health system needs. Historically, the diverse communities working in digital health—including government stakeholders, technologists, clinic... more

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MEPs Mobilising for Diabetes Blueprint for Action on Diabetes in the European Union by 2030

MEPs Mobilising for Diabetes (2021) CC2

Since the discovery of insulin nearly 100 years ago, advances in diabetes treatments and therapies have transformed the lives of people with diabetes (PwD), notably reducing the daily burden of its management. Newer technologies, including those driven by artificial intelligence, have the potentia... more

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Guidelines for the Clinical Diagnosis and Treatment of Dengue, Chikungunya, and Zika

Pan American Health Organisation PAHO (2022) C_WHO

Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduce clinical variability and, in essence, improve hea... more

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FEEDcities project. The food environment description in cities in Eastern Europe and Central Asia - Tajikistan

World Health Organization WHO, Regional Office of Europe (2017) CC

This technical report describes the results of a cross-sectional survey conducted in Dushanbe, Tajikistan, between April and May 2016, as part of the FEEDcities Project – Eastern Europe and Central Asia. The aim was to describe the local street food environment: the characteristics of the vending ... more

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Determinants Of Coital Frequency Among Married Women In Central African Republic: The Role Of Female Genital Cutting

Stewart H.; L. Morrison; R. White Journal of Biosocial Science (2002) C1

Journal of Biosocial Science / Volume 34 / Issue 04 / October 2002, pp 525 - 539 DOI: DOI:10.1017/S0021932002005254, Published online: 24 September 2002 This paper examines determinants of one aspect of sexual behaviour – coital frequency – among 2188 married women in the Central African Re... more

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Financing global health security: estimating the costs of pandemic preparedness in Global Fund eligible countries

Eaneff S., Boyce M.R., Graeden E., et al. BMJ Global Health (2022) CC

The COVID-19 pandemic demonstrated that the world was not well prepared to respond to an infectious disease threat of this magnitude. Countries across all socioeconomic and development categories have struggled to implement effective national responses. Substantial amounts of additional investmen... more

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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 on 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

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Rwanda: MEDICAL WASTE MANAGEMENT PLAN (MWMP)

Ministry of Health, Rwanda (2017) C2

Prepared for the Stunting Prevention and Reduction Project - The project Medical Waste Management Plan’s (MWMP) overall objective is to prevent and/or mitigate the negative effects of increased generation of medical waste on human health and the environment. The plan proposes measures to prevent t... more

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Asthma management in low and middle income countries: case for change

Mortimer, K.; Reddel, H. K.; Pitrez, P. M.; et al. (2022) CC2

Asthma is the most common noncommunicable disease in children, and among the most common in adults. According to the most recent estimates from the Global Asthma Network Phase I study, around one in 10 children and adults have symptoms of asthma and one in 20 school-aged children have severe asthma ... more

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Sierra Leone: National Strategy Plan for Combating Antimicrobial Resistance

Ministry of Health and Sanitation Sierra Leone (2018) C_WHO

Antimicrobials have been a critical public health tool since the discovery of penicillin in 1928, saving the lives of millions of people around the world. Today, however, the emergence of drug resistance is reversing the miracles of the past eighty years, with drug choices for the treatment of many ... more

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Stunting as a Risk Factor of Soil-Transmitted Helminthiasis in Children: A Literature Review

Fauziah, N.; Ar-Rizqi, M.A.; Hana, S. et al. Interdisciplinary Perspectives on Infectious Diseases (2022) CC

As a high-burden neglected tropical disease, soil-transmitted helminth (STH) infections remain a major problem in the world, especially among children under five years of age. Since young children are at high risk of being infected, STH infection can have a long-term negative impact on their life, i... more

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Sudan Humanitarian Response Plan COVID-19 Addendum

UN Office for the Coordination of Humanitarian Affairs OCHA (2020) C1

Sudan recorded the first COVID-19 case on 13 March 2020 and, at the beginning of July, the Federal Ministry of Health had confirmed that nearly 10,000 people had contracted the virus, including over 600 who died from the disease across the country. Although more than 70 per cent of the confirmed cas... more

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AFRICA CDC Framework for Antimicrobial Resistance, 2018-2023

Africa CDC (2018) C_CDC

Antimicrobial resistant (AMR) organisms are increasing globally, threatening to render existing treatments ineffective against many infectious diseases. In Africa, AMR has already been documented to be a problem for HIV and the pathogens that cause malaria, tuberculosis, typhoid, cholera, meningitis... more

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A systematic review of online interventions for mental health in low and middle income countries: A neglected field

Arjadi , R.; Nauta, M. H.; Chowdhary, N.; et al. Global Mental Health (2015) C1

Glob Ment Health (Camb). 2015; 2: e12. Published online 2015 Jul 14. doi: 10.1017/gmh.2015.10 Low and middle income countries (LMICs) are facing an increase of the impact of mental health problems while confronted with limited resources and limited access to mental health care, known as the ‘me... more

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The State of the World’s Antibiotics Report 2021

Siriam, A.; et al. The Center For Disease Dynamics, Economics & Policy CDDEP (2021) CC

A Global Analysis of Antimicrobial Resistance and Its Drivers. Since the first State of the World’s Antibiotics report in 2015, antimicrobial resistance has leveled off in some high-income countries but continues to rise in many low- and middle-income countries (LMICs), where access to antibiotic... more

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A triple dividend: The health, social and economic gains from financing the HIV response in Africa

Cook, R.; S. Jain; S. Aleyan; et al. Economist Impact (2023) CC

This report presents findings from research conducted by Economist Impact to assess the health, demographic, social and economic impacts associated with different scenarios for financing the HIV epidemic across 13 selected countries in Sub-Saharan Africa. The sponsorship of UNAIDS towards this repor... more