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Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
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 primary 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.
more
DHS Further Analysis Reports No. 108 - This report examines levels, trends, and inequalities in maternal health in Rwanda from 2010 to 2014-15 among women age 15-49 with a recent birth. The analysis
...
uses Demographic and Health Survey (DHS) data for 15 key indicators of maternal health: 6 for antenatal care, 3 for delivery, 1 for postnatal care, and 5 for barriers to accessing medical care. Levels and trends in these indicators were analyzed overall and by three background characteristics: women’s education, household wealth quintile, and region.
more
The report reveals weak national mental health services overburdened by the demands placed on them by the Syria crisis. Health facilities which previously provided integrated mental
...
health services in Syria have themselves become casualties of war, with most either destroyed, damaged or not functioning. The shortage of trained mental health care providers is viewed as critical, both in Syria and in the neighboring countries where refugees now reside. Strengthening and expanding these services is crucial for Syria’s longer term recovery because the need for treatment will last for years after the war ends.
more
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 an
...
d health systems teams) in July 2016, to understand how change in WASH services and quality improvements have been implemented in Ethiopia at national, 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.
more
Since February 24th, 2022, the beginning of Russia’s aggression against Ukraine, more than 80,000 women were expected to give birth. Therefore, understanding the impact of war on the perinatal
...
health of women is an important requisite to improve perinatal care. This narrative synthesis has two main purposes: on one hand, it aims to summarize the current evidence available based on perinatal health outcomes and care among perinatal women; on the other, it attempts to identify the gaps still present in research in relation to perinatal care.
more
Over half a billion children are living in areas with extremely high levels of floods and nearly 160 million children live in areas of high or extr
...
emely high droughts. The World Health Organisation (WHO) estimates that 26% of the annual 6.6 million deaths of children under five are linked to environment-related causes and conditions. Children are also disproportionately affected by pollution, not only in terms of death rates, but also in terms of cognitive and physical development. This report illustrates that environmental causes also have an impact on whether children are pushed to work and on the kind of work they engage in, the conditions of work, exposure to dangerous toxicants and the risk of exploitation. However, the report raises more questions than it answers as it is one of the first reports addressing the question, how environmental degradation and climate change affect the vulnerability of children towards exploitation.
more
Large-Scale UN Response Needed to Address Health and Food Crises
This report is based on interviews with more than 150 health
...
care professionals, Venezuelans seeking or in need of medical care who recently arrived in Colombia and Brazil, representatives from international and nongovernmental humanitarian organizations. In addition, researchers analyzed data on the situation inside Venezuela from official sources, hospitals, international and national organizations, and civil society organizations.
We found a health system in utter collapse with increased levels of maternal and infant mortality; the spread of vaccine-preventable diseases, such as measles and diphtheria; and increases in numbers of infectious diseases such as malaria and tuberculosis (TB). Although the government stopped publishing official data on nutrition in 2007, research by Venezuelan organizations and universities documents high levels of food insecurity and child malnutrition, and available data shows high hospital admissions of malnourished children.
more
Evidence- and rights-based national policies, guidelines and legislation play a key role in improving sexual, reproductive, maternal, newborn, child
...
and adolescent health (SRMNCAH), framing the enabling environment for equitable provision and accessibility of quality services. The SRMNCAH policy survey monitors the existence of national SRMNCAH laws, policies, strategies and guidelines and the extent to which they are aligned with WHO recommendations on SRMNCAH. This publication reports on the findings from the 2023 WHO SRMNCAH policy survey.
more
Nigeria is committed to end preventable newborn deaths, making life-saving interventions available to all mothers and babies who need them.
Nepal: Health Facility Survey 2015. Final Report
recommended
Only 10 per cent of households have electricity. Less than one half (46 per cent) of the households use basic sanitation facilities. Three in every four o
...
f the household population had basic drinking water services. More than one third of under-5 Malawian children (boys 39 per cent than girls 32 per cent) suffer from stunting with related health issues that can include cognitive impairment.
more
Primary Care: The Community Health System
The Ministry of Health and Family Welfare is committed to ensuring the effective implementation
...
of this strategy, which will contribute to the overall wellbeing and health of all adolescent boys and girls of Bangladesh
more
