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Toolboxes
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2
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 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.
more
There are many calls for improved integration between
primary care and public health, but also sizeable obstacles to achieving
this, such as differences in the ways the two sectors are organised and
financed, as well as differences in education, culture and approach.
This article, based on a new
...
Observatory policy brief, describes the
types of interventions that come into consideration, the principles
that should be followed, and the factors that can facilitate successful
collaboration. While there is no universal template that can be followed
by all countries, improved integration promises to yield substantial
benefits to patients and wider populations.
more
sur la base des orientations actuelles de l’OMS, 31 may 2021. Aide mémoire
This aide-mémoire presents information on use and procurement of masks for community outreach interventions, with a focus on those for malaria, neglected tropical diseases, tuberculosis, HIV/AIDS and vaccine-preventable
...
diseases. It details requirements for the different types of professionals involved (e.g. health workers, social mobilizers, data collectors, logisticians, insecticide spraying personnel, etc.), based on their level of risk of potential exposure to SARS-CoV-2.
more
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.
more
As the world population is growing and health care resources are in high demand the pressure on medical services is becoming higher. Developing countries are already at a crisis point in health care provision, and time demands a new approach in structuring medical resources. Primary care is t
...
he vital pillar for fundamental health care at community level and has been deemed as a cost-effective modality. In the West the primary care physician manages chronic medical conditions in communities and therefore reduces unnecessary hospital admissions. In the West, the primary care system is extremely well organised. Low-income countries must improve teaching, training and funding in primary care. In this article the urgent need for primary care is discussed in developing countries, and ways to minimise costs and improve clinical outcomes at community level.
more
Anywhere But Syria: How 10 Years of Conflict Left Syria’s Displaced Children Without a Sense of Home
After ten years of war, the vast majority of Syria’s children cannot imagine a future in their country, according to a new report by Save the Children. On average, 86% of Syrian refugee children surveyed in Jordan, Lebanon, Turkey and the Netherlands said they would not want to return to their cou
...
ntry of origin. Of children displaced inside Syria, one in three would rather be living in another country. Children who fled their homes are struggling to feel safe where they are now, as around two in five children of those surveyed by Save the Children said they face discrimination and a lack of education. Many feel they have no say over their future.
more
A living WHO guideline on drugs for covid-19
recommended
BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3379
Rapid Recommendation and visual graph. This is the fifth version (update 4) of the living guideline (BMJ 2020;370:m3379). When citing this article, please consider adding the update number and date of access for clarity. The publication of the RE
...
COVERY and REMAP-CAP randomised controlled trials triggered this guideline update, resulting in a strong recommendation for interleukin-6 (IL-6) receptor blockers (tocilizumab or sarilumab) in patients with severe or critical covid-19.
Prior recommendations: (a) A recommendation not to use ivermectin in patients with covid-19, regardless of disease severity, except in the context of a clinical trial; (b) a strong recommendation against the use of hydroxychloroquine in patients with covid-19, regardless of disease severity; (c) a strong recommendation against the use of lopinavir-ritonavir in patients with covid-19, regardless of disease severity; (d) a strong recommendation for systemic corticosteroids in patients with severe and critical covid-19; (e) a conditional recommendation against systemic corticosteroids in patients with non-severe covid-19; and (f) a conditional recommendation against remdesivir in hospitalised patients with covid-19.
more
This new plan has been developed to build on successes made and lessons learnt from implementation of the two initial plans and to provide a short to medium term strategic anchor against which preparedness and response plans to the corona virus disease COVID-19 epidemic in the country should focus o
...
n for the period June 2021 to June 2022.
more
Tackling COVID-19 misinformation. Ensuring communities have access to lifesaving public health information from trusted sources and are not misled by misinformation is essential to ending the COVID-19 pandemic.
In an effort to empower doctors and nurses – some of the most effective and trusted
...
messengers of public health information – to actively address COVID-19 misinformation and build vaccine confidence globally, the WHO welcomes this social media toolkit for healthcare practitioners, developed by the Government of the United Kingdom.
This toolkit aims to provide healthcare workers with the tools, skills and content needed to effectively share authentic and reliable information online. Centered around three core vaccine confidence messages, Vaccine Safety, Vaccine Development and Vaccine Reducing Risk of Sickness; this toolkit sets out three approaches: creating your own posts, posting the images and videos provided in the toolkit, or resharing vaccine information from trusted sources.
more
MAMI refers to the management of small and nutritionally at risk infants under six months of age (infants u6m) and their mothers.
June 2021. Shock-responsive social protection (SRSP) operates in contexts where rapid on-set disasters mean needs for assistance are acute and urgent. Monitoring and identifying problems in programme design and delivery are therefore critical. However, there is limited existing guidance on how to mo
...
nitor shockresponsive social protection in these contexts.
This Brief aims to help fill this gap. It does not provide a blueprint for developing monitoring indicators, but it presents a guiding framework with key questions and key issues to consider when monitoring SRSP to understand how the intervention contributes to broader crisis response.
more
The primary audience of this report with the compendium of resources are youth engagement practitioners in the Red Cross Red Crescent National Societies as well as technical experts and policy makers across the humanitarian landscape that thrive for meaningful interventions with and for children, ad
...
olescents, and young adults experiencing the impact of the COVID-19 pandemic.
more
Evidence from a systematic review on antenatal zinc supplementation was evaluated as part of the World Health Organization (WHO) antenatal care (ANC) guideline development process in 2016, and the following recommendation on zinc supplementation was made: “Zinc supplementation for pregnant women i
...
s only recommended in the context of rigorous research.” The Guideline Development Group (GDG) made this recommendation because it felt that the evidence on the intervention was incomplete and that more research was necessary.
more
Country Strategic Plan Evaluations (CSPEs) encompass the WFP strategy and entirety of WFP activities during a specific period. Their purpose is twofold: 1) to provide evaluation evidence and learning on WFP's performance for country-level strategic decisions, specifically for developing the next Cou
...
ntry Strategic Plan (CSP) and 2) to provide accountability for results to WFP stakeholders. These evaluations are mandatory for all CSPs and are carried out in line with the WFP Policy on Country Strategic Plans and the WFP Evaluation Policy.
more
Partout dans le monde, les sociétés ont produit, adapté et fait évoluer leur habitat pour répondre au mieux à leurs besoins et
aspirations, et ce en faisant le meilleur usage des ressources naturelles disponibles localement et en développant leurs propres
capacités. Les stratégies qui e
...
n résultent, à la fois techniques, architecturales ou encore sociales, tirent le meilleur parti de
l’environnement local tout en se protégeant de ses aléas. Il résulte de ce processus un corpus de connaissances locales uniques,
riches et variées
more
Over the past two decades, Afghanistan has depended on international donor support to fund essential services like health care. But this donor support has been falling for years and will likely to continue do so—perhaps precipitously—following the announcement by United States President Joe Bide
...
n that the US will withdraw all US forces from Afghanistan by September 11, 2021. This decline in funding has already had a harmful—and life-threatening—impact on the lives of many Afghan women and girls, as it affects access to, and quality of, health care.
more
Guide de mise en œuvre à l’intention des Sociétés nationales de la Croix-Rouge et du Croissant-Rouge
orientations provisoires, première publication: 10 février 2021, mise à jour : 21 avril 2021, dernière mise à jour : 30 juillet 2021
